What causes adhesions after enbloc-total capsulectemy implant removal if all scar tissue is supposed to be removed? If mastopexy is not performed with explant, does that cause visible adhesions?
Removal of the breast implants and capsules leaves an empty space. That space has to heal back together and that healing occurs by scar formation. Some scars tighten and can pull at the tissue, creating indentations or skin folds. Think of the woman who had a C-section. The scar in the lower abdomen sticks to the abdominal wall and this can create a “shelf” where the tummy skin folds on itself. The bigger the baby, the more stretched the skin gets, and the larger the fold can be. With implants, the same situation occurs: the breast skin was enlarged by the implant. When the implants is removed there is more skin than is needed, and the scarring can cause folds or wrinkles to appear. Remedies might include a breast lift or fat transfer. Consult with your plastic surgeon regarding options. But be sure to wait at least 6 months after the implant removal, and during that time massage the breasts to try and stretch out any adhesions.
Thank you for sharing your excellent question. Any time the body is forced to heal from a surgery it does so through a “scar response.” Although the scar tissue around the implants were removed, your body will produce more as it attempts to heal from the procedure itself. Adhesions that are visible do not occur in all patients, so the decision to pursue a mastopexy would depend on the expectation of loose skin development after enblock capsulectomy. Hope this helps.