Capsular Contracture Repair and Removal of Breast Implants

Plastic Surgeon
A consultation at Boerhaave always takes place with the plastic surgeon who will be treating you. During this personal consultation, you will discuss the medical details and your preferences regarding the replacement of your breast implant. Afterward, photos will be taken, and your breasts will be examined and measured. Key factors to consider include skin elasticity, the quality and quantity of breast tissue, and any irregularities in the breast tissue. Specific information on these points will help you make the right choice.

Based on this, you will receive a recommendation on which treatment best aligns with your wishes. You will also have the opportunity to express your preferences in front of a mirror. If you opt for a larger implant, you can “try on” the selected size to help you make a well-informed decision.

We recommend that women aged 40 and older have a mammogram performed beforehand. This is not necessary if you have had one within the past year.

Consultant
Following your initial consultation, you’ll have a meeting with your consultant. The purpose of this meeting is to inform you about the general procedures that need to be arranged. Would you like to read more about your initial consultation? More information about your initial consultation at Boerhaave.

Follow-up Appointment
We understand that you may feel overwhelmed by the amount of information during your initial consultation. If you feel uncertain about the decisions made afterward, you can schedule a separate appointment to discuss them in detail with your plastic surgeon.

If you’ve chosen a larger implant, you can try it on again. This allows you to take your time and make a well-considered decision about which shape and cup size will give you the desired result.

Before the procedure, the plastic surgeon will mark your breasts according to the treatment plan. General anesthesia is then administered.

If possible, an implant replacement is performed through the existing scar. This scar is often four to five centimeters long and can be slightly extended if necessary. If the original scar is located in the armpit or around the nipple, you will have a new scar in the natural breast crease.

Removing or Incising the Capsule
The most appropriate treatment for capsular contracture is the complete removal of the capsule surrounding the breast implant, also known as a capsulectomy. This is the procedure most likely to prevent future recurrence of capsular contracture. Capsulotomy—that is, simply making an incision in the capsule—carries a much higher risk of the problem recurring.

After the capsule is removed, the new implant is placed. The pocket is then closed, the skin is sutured with dissolvable sutures, and the wound is covered with Steri-Strips. A water-repellent, transparent bandage is applied over these.

If you have your implants removed without replacing them, a more extensive procedure is often necessary. This is because your skin may have stretched, and without implants, your breasts often remain saggy. Through reconstruction, the plastic surgeon can achieve an aesthetically pleasing result.

In total, the procedure takes one to one and a half hours.

After the surgery, you will usually stay at the clinic for another three to four hours, and you may go home only once the nurse and the anesthesiologist deem it safe to do so. However, you may start eating easily digestible foods right away, such as water, tea, and crackers.

Immediately after the procedure, the treated area will be bruised, tender, and swollen. For the first few days, your breasts may also feel sore, and you may experience muscle aches and mild tenderness around the treated area. In addition, the skin will feel tight and taut as it adjusts to the new breast size. The same applies to the breast tissue.

It is important that you take it easy after the surgery. For six weeks, you should avoid intense exercise, heavy lifting, and strenuous work.

Scars
Your scars will initially be red and swollen. This will subside after a few weeks. It’s good to know that a scar takes one to one and a half years to fully heal. Also, remember to keep the scars out of the sun and to care for them properly.

The clinic will provide you with a special scar care cream. Once the wound has closed and the scabs have fallen off, you may begin applying this scar cream. In addition, always use sunscreen with an SPF of 30 or higher for the first year to protect your skin.

Sports Bra
Finally, it is important that you wear a sports bra day and night for six weeks. This will be fitted after the surgery and provided to you free of charge by the clinic.

The final result will not be visible until after a few months. In the initial period, you’ll experience some discomfort, but after a few months, you’ll be able to enjoy your breasts, which will have a new shape and, possibly, more volume. In general, the results are permanent. As long as your breasts remain supple to the touch and continue to look good, there’s no reason to replace the implants. After ten years, you can come back to the clinic for a follow-up visit.

It is important to realize that any surgical procedure can involve risks and complications. This is also true for plastic surgery procedures. However, the risks and likelihood of complications are low, as the patients are generally healthy individuals. In addition, we minimize these risks to an absolute minimum through our thorough patient education, comprehensive medical history review, and professional approach. You can also help reduce certain risks by carefully following the instructions you received beforehand.

Possible complications may include:

• Hematoma (a collection of blood under the skin that requires removal)
• Adverse reaction to the anesthetic
• Postoperative bleeding
• Infection
• Capsular contracture
• Implant rupture
• Change in sensation
• Permanent scarring
• Damage to underlying structures
• Unsatisfactory aesthetic result.

Capsular Contracture
Capsular contracture may recur even after surgical procedures. This can occur shortly after surgery or not until years later. Unfortunately, it cannot be predicted, but the risk does increase over time and can develop on one side or both sides. After 10 years, the risk of capsular contracture is 10 to 12 percent.

Capsule formation is more common when the implant is placed in front of the pectoral muscle.

Smoking
Did you know that patients who do not smoke or are not exposed to secondhand smoke have a significantly lower risk of complications and other risks? If you do smoke or use tobacco or nicotine products at the time of surgery, you have a higher risk of complications, such as skin necrosis and poorer wound healing. In addition, it can have a negative effect on anesthesia, potentially resulting in an increased risk of bleeding. It is therefore important to stop smoking at least four weeks before surgery and to continue abstaining throughout the entire recovery process. Even if you are exposed to secondhand smoke, you may be at an increased risk of complications.