Breast Implant Capsule – Treatment of Capsulectomy

Breast Enlargement: Capsule formation following breast enlargement procedures treated with replacement of the breast implants behind the capsule to soften the outline of the breast implant. Mr. Adrian Richards,  breast surgeon specialist, takes you through the surgical procedure of  Breast Implants Exchange step by step.

Hello. My name’s Adrian Richards. I’m the Surgical Director of Aurora Clinics based here in the United Kingdom. Today I’m going to be showing you an operation I performed earlier on which was on a lady who had breast implants in for the last ten years. Recently she’s noticed them growing hard and developing capsules, which are the firm areas. As the body sort of wards off the implant, it makes a firm wall around them.

She’s a very slim lady. So in this video I’m going to be showing you how I placed the new implant behind the existing capsules to give her that little bit of extra padding to cover up the implant and reduce the risk of rippling or, you know, visible outline of the implant which sometimes you can see in the upper portion.

Here we can see our patient just literally before surgery where I’ve taken these photographs. As you can see, the implants deform the breasts. The breasts are lying in a low position, and the capsules of the breasts have really contracted there to produce an unnatural shape which is very firm. When I, in the operation, actually palpate the breas, the breast is very firm because it’s being constricted with that capsule.

Now, I’m going to use the old incision. The old incision from previous surgery is very long. It is 9 cm long. Now, I’m only going to need to use the central 4.5 to 5 cm of that incision. I make my incision actually within the old incision. Now, you can see here I’ve actually gone behind the old capsule. So, you can see here, I’m behind the capsule, and then I actually go into the capsule here and I am releasing the implant which would be under quite a lot of tension because it’s quite tight there. It’s been tightly constricted. I don’t know if you can see how it sort of just wants to come out because it’s been so tightly constricted.

Now, that was the back plate. There’s a bit of tissue that was adherent to the implant. You can see here that the implant was ruptured. Most of the silicone is inside the implant, but you can see a small hole here in the shell of the implant on that side.

My next stage is really to wash everything out and make sure all the silicone is removed, everything’s nice and clean. Then you can see this is where I am going to put the implant, in there. So that will be behind the capsule. So I’ve got that extra layer of coverage over the implant.

This is my sizer, which is a temporary inflatable implant which I’m going to place behind the capsule because I am going to need the capsule as an extra layer. Then I’m going to sew everything up with absorbable stitches. That’s the right side completed. I performed exactly the same on the left, and the implant on that side was intact.

You can see here a slightly more natural appearance to the bust and much, much softer bust. Here you can see both implants. That’s the one on the left which actually was intact. The one on the right I’m just going to show you here, with that little hole in it. It was really a good time for this lady to have her implant removed before any of that silicone left the implant there. This is a really good technique which I think works really well.

Thank you for watching the video. A big thank you to the patient for letting us show the video. I hope you found it useful and informative. If you do feel you have got some capsules, they can vary from just very slight firmness to much harder. They can actually distort the breasts, as in this case, and can cause some discomfort in the breast. If you feel you have got capsules, we’d be more than happy to see you. You can send us a photo to info@aurora-clinics.co.uk, and I’ll give you an opinion as to the best way forward. Or better still, come see us in clinic and either I or one of our speciality surgeons will be able to discuss the best way forward for you.

Unfortunately capsules can occur, and the best way of treating you if you have got this problem is really very individual. If you can, we’d love it if you could come and see us and we could discuss the best way forward for you.