Patient 4 Gallery

Before and after bilateral explanation, total capsulectomy and mastopexy (breast lift via local tissue rearrangement and auto-augmentation) in a 56-year-old woman with contracted, painful over 30-year-old saline breast implants. She knew she no longer wanted breast implants and she wanted her breasts to be lifted and smaller.

She had thick, firm scar tissue that had formed around her implants, and it felt a little “crunchy” to the touch. Calcification of the internal scar tissue (capsule), a phenomenon that can occur over years in response to chronic inflammation from bacteria around the implant, was suspected based on clinical examination.

While uncomplicated, non-contracted saline implants can simply be deflated in the office or removed under local anesthesia, saline implants with contracted, thick capsules +/- calcification require removal of the entire capsule under general anesthesia (total capsulectomy) to remove all firm calcified tissue. “En bloc” capsulectomy (where the capsule is not opened and the entire capsule and shell is removed as a whole) was not indicated, since there was no cancer or potentially messy ruptured silicone inside. Video of the inspection of the calcified old saline implants and calcified capsule can be seen here.

Her surgery involved opening the capsule, removing the breast implants, and removal of the entire capsule. Images below show the implants, which were intact but had calcifications stuck to their shell, and the internal calcified capsule before its removal. The old pocket was thoroughly washed, and a mastopexy filled the old implant space with her own breast tissue. Liposuction removed excess fat from her armpits and bra rolls.

Follow up photos are shown 8 months after surgery. She absolutely loves her natural looking, smaller and more shapely breasts! Her scars will continue to fade over the next year.