Before and after bilateral breast augmentation revision in a 45 year old woman. Her 20+ year old silicone implants had ruptured (confirmed by MRI) and her capsules around the implants were hard and crunchy, causing pain and deformity, seen best with her arms above her head.
When some of the older generation implants break down over time, a term that is called breast implant “rupture” (however, the implant does not actually explode like a rupturing volcano – it instead breaks down and the silicone remains in the “pocket”), the body can mount a significant inflammatory response, resulting in hard areas of calcification of the breast implant capsule.
In this case, removal of the entire calcified capsule was necessary, called a “total capsulectomy”. This additional scar tissue removal, which is extensive and requires general anesthesia and drains for several weeks after surgery, is not necessary for in-office implant exchange or for straight explantation surgery when the implant is intact. Total capsulectomy is needed if the implant has broken down inside the pocket and the capsule is involved in the deformity or causing pain, as it was in this case.
Following capsulectomy, the pocket was washed out and a new silicone gel breast implant was placed on top of the muscle, in the subglandular position. Our current breast implants have a longer warranty (10-20 years) on the device, and calcification formation is much rarer with the devices that are used today. Liposuction removed unwanted armpit fat from the “axillary rolls”. Follow up photos are shown two months after surgery.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
