Options for Treating Capsules around Breast Implants17th February 2011
Breast Capsulotomy / Capsulectomy
Options for Treating Capsules Around Breast Implants
Hello, my name’s Adrian Richards. I’m a plastic and cosmetic surgeon and the Surgical Director of Aurora Clinics based here in the south of England and in London. Today I’m going to be talking a little bit about capsules, which are a reason why some people do choose to have further surgery to their breasts after an implant.
The first thing, what is a capsule? A capsule is basically the lining around your breast implant. So whatever type of implant you have in your body, your body recognises it as a foreign material and tries to wall it off, and it’s that wall which is the capsule. So this can occur with any implantable device — heart valves, hip replacements, whatever it is, and the same applies for breast implants.
Now, in most people, this lining stays very soft and supple and walls off the implant, but you really wouldn’t know it’s there. However, in some people this capsule becomes thicker and firmer, and we don’t really know why this occurs. The reason we use textured, which are furry implants, is that furry implants, textured implants, have been shown to have a less rate of capsular contracture. There are also other types of implants such as polyurethane implants, which you can hear me discussing with Daniel Fleming from Australia in one of our podcasts, which are available on the websites, which have a very, very low rate of capsular contracture.
So we don’t know why it occurs. It may occur due to very low-grade inflammation. Certainly I have had patients years after a breast enlargement who have developed a tooth infection who have developed capsules which they say appeared approximately at that time. So some people get capsules. About five per cent of people get capsules which are bad enough to cause them concern.
What the capsule does is it acts like shrink wrap around the implant. So it contracts and pulls in. Massage may help it. Once a day can help stretch the capsules, but they may still develop. As they contract, they tend to make the breast implant feel firmer because the shrink wrap is really sort of constricting around them and so they feel firmer. Then if the capsules progress, they can cause pain and distortion in the appearance of your bust.
So if you do develop capsules, you’ll probably realise that perhaps the bust has become slightly firmer, slightly more uncomfortable. If that does occur, it really would be sensible probably to come in and see either myself or one of our other surgeons or another plastic surgeon to discuss the options available for you. These essentially either involve capsulotomy, which means internal division of the capsules, or capsulectomy, which is the medical word for removal. So the capsules can either be freed up from inside, capsulotomy, or removed, capsulectomy, and then a new implant replaced in the position.
So capsules, in summary, are rare. They can occur. It’s unfortunate if they do occur. If they do occur, you either need to consider a capsulotomy or a capsulectomy and possibly the use of a polyurethane coated implant to reduce the risk of the capsules coming back. It is unlikely they will come back. Most people who have capsules and have them successfully treated they don’t come back. Your risk is higher than if you never had capsules at all, but by no means everyone who has capsules gets them back.
So I hope that’s clarified some issues about why you may wish to have your implants changed and hopefully clarified any confusion, if you’ve got any, about capsules and the differences between capsulotomy and capsulectomy.
Thanks very much for watching the video. I hope you’ll be able to watch more in our series of videos on our website.