Capsulotomy in Breast Implant Surgery Overview

Capsulotomy is a procedure in which part of the "capsule" of scar tissue surrounding a breast implant is removed.

The procedure is performed as a means of fixing capsule formation or capsular contracture, the most common complication of breast augmentation surgery. 

Capsular Contracture

Capsular contracture occurs when scar tissue forms around breast implants. This complication occurs in approximately 10 percent of people who've had a breast implant, and it typically happens within the first twelve months after surgery.

The likelihood of a contracture developing is lower with the use of textured implants, submuscular placement, and polyurethane coated implants.

During capsular contracture, the breast may harden, look and feel different, and may feel uncomfortable as the tissue tightens around the implant. 

While some scientific data supports an immune response as the cause of this complication (meaning a person's immune system reacts against the implant causing a chronic inflammatory response), it's also been thought that an infection from multiple bacteria may also contribute to it. 

Capsulotomy Procedure

You may need a surgical procedure if you've had a moderate to severe contracture and can feel firmness of the capsule. These types of capsule contractures are graded and known as Bakes III and Baker IV capsules.

There are two ways a capsulotomy can be done:

• Open Capsulotomy: The scar tissue (capsule) is surgically released and/or partially removed through an incision.
• Closed Capsulotomy: Vigorous manual compression is applied from the outside of the breast (no incisions are made) in an attempt to break up the scar tissue and release the contracture of the capsule.
  

Recovery After Surgery

Postoperative swelling can last for several weeks. If you feel a lump of any kind during this time, visit your surgeon promptly, especially if it increases in size quickly. The lump could be a collection of blood or fluid or a reactive lymph node. These complications may require further treatment.

Preventing Capsular Contracture

There may be some ways to prevent capsular contracture from happening in the first place. Some surgeons may recommend that you perform implant displacement exercises post-operatively. Your surgical team will teach you what you need to do.

Be sure to follow-up closely with your surgeon, and tell them about any worries or new symptoms promptly.