Before and after bilateral explantation in a 54-year-old breast cancer survivor who wanted to “go flat”. After bilateral mastectomies, chemotherapy and left breast radiation, she had undergone several implant reconstruction surgeries, and unfortunately developed recurrent Grade IV (painful) capsular contracture.
When she came to our office, she considered a free flap reconstruction such as the DIEP flap or TUG flap, but in the interim, she wanted her implants, and all the associated scar tissue removed. She was a candidate for simple removal of the implants without capsulectomy under local anesthesia, but this could have created more deformity due to the thick, firm scar tissue that had developed over years of recurrent breast implant infections.
Explantation removed the implants and capsulectomy removed the thick scar tissue from the inside of the pocket. A total capsulectomy refers to removal of every part of the capsule – this procedure takes three to four hours to perform, and requires general anesthesia, drains and a month-long recovery. Extra breast skin was not removed since she was still considering breast reconstruction in the future, and removal of additional skin might negatively affect future breast reconstruction aesthetics.
Follow up photos are shown a year and a half after breast implant removal. Note that her left radiated chest has thinner skin and less padding than her right non-radiated chest. Upon awakening, she felt immediate relief of pain and pressure, and she does not mind being “flat”!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
