Before and after bilateral breast revision in a 30-year-old woman with Grade IV capsular contracture. Her previously placed breast implants had become infected after an infection following a complicated root canal. Her body responded to bacteria entering her bloodstream and traveling around the breast implants by forming scar tissue that contracted so tightly around the implants that she not only had firmness (Grade II capsular contracture) and deformity (Grade III), but pain (Grade IV).
Her revision involved removal of the old breast implants and returning them to the breast implant manufacturer for warranty replacement. Most companies cover the cost of new breast implants for Grade IV capsular contracture within their warranty period (10 or 20 years).
Capsulectomy removed excess scar tissue on the inside of the pocket and opened up a more natural space for a new implant. A representative sample of scar tissue from inside the pocket was sent for microbiological analysis, as is standard in our practice. Thankfully, no bacteria were detected, so the risk of recurrence of contracture was small (if bacteria had been detected, she would have been prescribed an appropriate oral antibiotic for two weeks and close clinical follow up would take place).
New smooth round silicone gel breast implants were placed in the subglandular position. Her drains remained in place for a week, and she began implant massage within days. Grade I on the Baker grading scale indicates a soft, normal looking implant – which is what she achieved after surgery.
The mastopexy on the left breast was redone, and a balancing mastopexy was performed on the right to achieve the best symmetry. Adding a breast lift requires making additional lollipop-shaped incisions on the breast to lift the nipples and tuck baggy lower pole breast skin.
Follow up photos are shown 3 months after surgery. She will continue to see her Dentist regularly and take preventative antibiotics before teeth cleanings or any procedure of the nose, mouth or gut.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
