American Society of Plastic Surgeons
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mareee
one year ago
Answered

capsular contracture

Hello! 3 months post-op after breast implants, I have a capsular contracture. I have a surgery date for my surgeon to take out the implant, take the scar tissue off and put it back in. They are planning to re-insert the same implant. I read online it is better to replace with a new implant, to reduce the chances of it happening again. I was curious if this matters. Thank you!

Procedure: Breast Augmentation
Type: Question

Replies 8

Eugenio Aguilar
ASPS Surgeon

Your surgeon is doing the right thing. It is not mandatory that a new set of implants be used especially if this has happened so quickly after your operation. The pockets needs to be washed out thoroughly and the implants soaked in antibacterial solution while they are out. Capsular contracture is more apt to occur with smooth implants but it is still a small percentage.

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Jacob Gerzenshtein
ASPS Surgeon
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What kind of implant was used to start with?

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Lawrence Glassman
ASPS Surgeon
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It is not wrong to reinsert the same implant. That being said, I normally use a new implant in order to minimize any possible increased exposure to contamination and thus increase the risk of capsule contracture. The patient incurs an additional cost for the new implant. After having an early capsule contracture following your first operation, your chance of having another capsule contracture is higher than the average breast implant patient. This increased risk is present even when a new implant is used.

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Trent Douglas
ASPS Surgeon
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Thank you for your question and doing your homework with ASPS member surgeons. I am going to respectfully disagree with the posts that have already been made. Breast implants are designed as single use devices, In my opinion, the safest and best thing to do is to replace the implant with a new one. There are many theories regarding the origins of capsular contracture and residual biofilm on the existing implant may further increase your chance of having a recurrent capsular contracture. While there are many acceptable ways to perform revision breast surgery, in my practice, I always use a new implant when it is deemed necessary to exchange implants for whatever reason and at whatever time it has been since surgery. Best wishes on obtaining a great result and a speedy recovery.

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Troy Pittman
ASPS Surgeon
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Your surgeon should absolutely NOT use the same implant. The leading theory of capsular contracture is biofilm produced by bacteria. In theory, your pocket is contaminated. Removing the implant and reusing it will compromise the sterility of the pocket. Your implant warranty should cover the cost of the new implant anyway. I would suggest you ask your surgeon to use a new, sterile implant. If your warranty does not replace the implant, it’s well worth spending the money to get a new one.

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Nelson Castillo

Thank you for sharing your excellent question. Because of the thought of contamination leading to capsular contracture I would advocate using a new implant versus the one currently in place. Hope this helps.

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Curtis Wong
ASPS Surgeon

Truly a contracture or implant malposition??? If a contracture, the standard of care now is to create a new pocket (outside of your old capsule) and use new implants. Yes, old school teaching suggests an aggressive capsulotomy (lot of releases) and using the old implant can work, and anecdotally, it has. Implants nowadays come with warranties that allow for a new implant from the manufacturer so I'm wondering why your surgeon cannot get a new implant for you. And if implant malposition, releasing scar and using the same implant is fine.

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Jeremy White
ASPS Surgeon

I would definitely ask your surgeon to use a new implant. It is worth the expense and some companies may cover the cost for you, considering how quickly the capsule developed. One of the prevailing theories today regarding a capsule is that there are small amounts of bacteria that get onto the implant and cause this inflammatory reaction that walls off the implant. Therefore, if you have a true breast implant capsular contracture, start fresh!

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