A capsulectomy, or breast implant replacement, is the removal of the scar tissue (capsule) that forms around any prosthetic implant. After implantation of any foreign prosthesis, the body forms scar tissue around it encapsulating it. This process happens following any breast augmentation or reconstruction using a saline or silicone gel implant. It is a normal process. In some instances, however, the scar (capsule) around the implant may thicken and contract. As a result, the breasts may feel much harder on palpation. The shape may become significantly distorted and one may experience some discomfort or even constant pain. Performing a capsulectomy and replacement of the breast implants should alleviate the discomfort and improve the appearance and feel of the breasts.
Women who are experiencing a capsular contracture that is associated with breast shape dysphoria are good candidates for the procedure. Additional symptoms of pain or rupture of a silicone gel implant are even stronger indications for proceeding with surgical correction. Women’s breasts change with time and only performing a capsulectomy with replacement of the breast implants may not be sufficient in some instances to return the breast shape to the original post augmentation or optimal result. Assessment for the need of implant size and shape change as well as some form of a breast lift (mastopexy) is imperative. These decisions should be discussed and made by you and Dr. Nikolov during your consultation.
As with any type of surgery, there are risks and complications associated with plastic surgery. The degree of risk will depend on a number of factors, including whether the surgery is to a small or large area of tissue, the surgeon’s level of experience and the overall health of the person having the procedure.
Some procedures carry specific risks, but general risks include infection, scarring and the failure of the repaired area of skin due to a restricted blood supply.
Dr. Nikolov takes great pride and care to ensure a beautiful outcome with each procedure to minimalize any risk.
Planning Your Surgery
In your initial consultation, Dr. Nikolov will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts.
Be sure to discuss your expectations honestly and Dr. Nikolov will be equally honest with you, describing your alternatives and the risks and limitations of each. You may want to ask for a copy of the manufacturer’s insert that comes with the implant he will use, if replacement is needed. Be sure to tell Dr. Nikolov if you smoke, and if you’re taking any medications or vitamins.
During your consultation the type of anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved will all be explained to you. Some insurance companies consider a capsulectomy to be medically necessary. Discuss with our office the possibilities for insurance coverage. You may wish to verify with your insurance company ahead of time to find out if this procedure is covered under your policy.
Preparing For Your Capsulectomy Surgery
During your preoperative appointment we will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Where Your Surgery Will Be Performed:
Dr. Nikolov may prefer to perform the operation in an office facility, a freestanding surgery center, or a hospital outpatient facility. Occasionally, the surgery may be done as an inpatient in a hospital, in which case you can plan on staying for a day or two.
Types Of Anesthesia:
Breast augmentation can be performed with a general anesthesia, so you’ll sleep through the entire operation. In some situations Dr. Nikolov may use a local anesthesia, combined with a sedative to make you drowsy, so you’ll be relaxed but awake, and may feel some discomfort.
You’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor.
Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades.
Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.
Getting back to normal
You should be able to return to work within a few days, depending on the level of activity required for your job.
Follow your Dr. Nikolov’s advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery.
Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.
Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable reading, as discussed earlier.
Your New Look
For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance. Onset of a capsular contracture can dampen the spirits causing pain, discomfort, embarrassment and self consciousness. A capsulectomy can bring back the satisfaction and confidence of your original result.
Regular examination by Dr. Nikolov and routine mammograms for those in the appropriate age groups at prescribed intervals will help assure that any complications, if they occur, can be detected early and treated.