Patient 53 Gallery

Before and after bilateral explantation (breast implant removal), total capsulectomy and breast lift in a 78 year old woman.  She was fit, healthy and very active; her contracted, oversized breast implants no longer suited her.  Although they weren’t painful, she wanted them out and for a smaller, perkier but age-appropriate breast.

Capsular contracture is graded from Grade 1 to Grade 4.  Grade 1 is a normal, soft breast implant.  Grade 2 is an implant that looks normal but is firm to the touch.  Grade 3 contracture is a distorted implant.  Grade 4 capsular contracture is painful.  This patient’s contracture would be graded a three based on her obvious deformity but absence of pain. 

Both implants were removed and a total capsulectomy was performed in the operating room under general anesthesia.  A total capsulectomy was done in this case as her implants were old silicone and were ruptured.  The capsule around them was firm, thick and stuck to the implant. 

In cases of implants that are intact (not deflated or ruptured/broken down), a total capsulectomy is not always required.  Breast implants are often removed in the office under local anesthesia.  The old capsule tends to shrink and soften with time since the implant is out and the body does not have a foreign body to react to. 

In this case, the patient’s breast tissue was stretched out around the implant and required a major rearrangement in the form of a breast lift.  She went home the same day and took 6 weeks off playing tennis and her volunteer activities. 

Follow up images are shown one year after surgery.  Her scars are mature and she is very pleased with her results.  She cannot believed she lived as long as she did with her “coconuts”!!!