Breast Capsulectomy Surgery

Breast capsulotomy or capsulectomy are surgical procedures that release or remove firm breast capsules that surround breast implants.

If you are unfortunate enough to have developed firming of the capsule around your implant (capsular contracture), you need to discuss the best option with a specialist breast surgeon who is experienced in dealing with this specific problem.

Considering Breast Capsulectomy Surgery?

When you have any kind of implantable device inserted into your body, your body will develop a lining to wall it off. This lining is a form of scar tissue and is known as a capsule. This happens when a breast implant is inserted. In most people these capsules remain soft and pliable and you will not be aware that you have them. However, approximately 4-6% of people with breast implants will develop thicker than normal capsules, known as capsular contracture.

These hardened capsules can act like cling film; constricting your breast implants. This can cause:

  • Firmness of your implant
  • Tenderness of your breasts
  • In severe cases changes in the shape of your breasts

There are two treatment options available if you are suffering from capsular contracture:

Breast capsulotomy – releases the capsule internally

This is the process of releasing the implant surgically from the inside so it is less restricted.

Breast capsulectomy – removes the capsule

Breast capsulectomy removes the lining around the implant, removing the actual capsule. This can come in two forms: subtotal capsulectomy or a total capsulectomy. A subtotal capsulectomy only removes some of the lining whereas a total capsulectomy removes the entire lining all the way around the implant.

Our approach here at Aurora is to perform a breast capsulectomy. However if you are small busted we may choose to perform a breast capsulotomy instead. This is because if the capsule is removed, you are reducing the thickness of the breast tissue over the implant which can lead to the implant looking superficial under your skin. In this case, we may opt for a capsulotomy and move the capsule forward so it sits in front of the implant, giving you slightly more padding.

Depending on the severity of your capsules and your body shape, your plastic surgeon will advise on the most appropriate treatment for you during your consultation.

Once the capsule has been removed, it is then normal to replace your old breast implant with a new one. The total surgery time is usually 2-3 hours and is normally performed under a general anaesthetic. You will also be required to stay in hospital over night.

How will it impact your life?

If you are experiencing discomfort from your constricted breasts then having this corrected will make day-to-day tasks such as lifting or going to the gym much easier and more comfortable. If you are suffering with changes to the shape or position of your breasts, possibly with some asymmetry then undergoing this surgery will boost your confidence as your implants will begin to look like their natural shape again.

Is Breast Capsulectomy right for you?

Capsular contracture can cause pain and distortion in the appearance of your bust. If you have developed capsules, you will probably realise that perhaps your bust has become slightly firmer and more uncomfortable.

There are four grades of capsular contracture known as the Baker Grades:

  • Grade 1 – your breasts appear normal and are soft and pliable
  • Grade 2 – a slight hardening of your breast implant
  • Grade 3 – slightly firmer with some distortion in the appearance of your breast, which normally means the capsule is drawing in and drawing the implant upwards. This can also lead to rounding of your implant
  • Grade 4 – the one associated with discomfort. In severe capsules, you can feel a tenseness in the breast as the capsules progress

It’s important that you seek advice from a plastic surgeon as soon as you feel you may be suffering from capsular contracture. This will allow your surgeon to diagnose the problem and offer you the appropriate options to prevent the capsules from advancing and causing you more discomfort.

As with any type of surgery, your surgeon will discuss the pros and cons of going forward with surgery and will give you time to decide which option is right for you.

After your surgery and beyond…

Following this type of surgery, you will be able to walk around and perform light activities the day after your operation. Strenuous activity, however, must be avoided for at least 4 to 5 weeks and most people return to work 1-2 weeks following surgery.

Your surgeon will usually use your old scar during your surgery. This means you will not have any more scarring than you did before. This could be in the crease under your breast, the area near your armpit or through the areola (the dark area surrounding your nipple).

There is always the possibility that your capsules may return. However, the risks of developing further capsules can be reduced by:

  • Totally removing the capsule – total capsulectomy
  • Replacing your existing breast implants with polyurethane coated breast implants which have a very low risk of capsular contracture.

The next step

We always encourage people to do as much research as they can when considering cosmetic surgery, so for more information on breast capsulectomy surgery: