Capsulectomy

What Is A Capsulectomy?

A capsulectomy is a medical procedure to remove capsules that sometimes form around breast implants. The body produces thick scar tissue to form a wall, or capsule, around what it sees as a foreign object that could be a threat. The capsule is not a problem in itself, but if it gets too thick it can distort the shape of the implant, may cause it to harden, and could even damage it.


Is This Problem Unique to Breast Implants?

No, capsules can form around all sorts of objects that are implanted in a body, such as a hip replacement or a pacemaker.

Does Everyone Get Capsules After Implants?

A capsule is inevitable, but it will not necessarily be problematic. Exactly which patients will get excessively thick capsules is hard to predict, but possible contributing factors include the placement of the implant, infections, smoking and suffering a haematoma (a very deep bruise, often below the skin) near the implant.

What Does a Capsulectomy Involve?

In a capsulectomy, the surgeon will cut through the scar tissue and remove the implant. In most cases the surgeon then inserts a temporary implant and fills it with saline solution to measure the space that is left inside the capsule. Based on this information, the surgeon may remove some of the scar tissue that forms the capsule. The temporary implant comes out and, depending on the space available after any removal of the scar tissue, either the original implant or a replacement goes back in; this is known as a sub-total or total capsulectomy respectively.


What Happens During The Surgery?

When you arrive for your capsulectomy, your surgeon should go over in detail what’s expected to happen, and the nurses should help you feel relaxed and comfortable ahead of the procedure.

capsulectomy

A capsulectomy is carried out under a general anesthetic. Your surgeon will make an incision through the existing scar tissue to remove the implant so as to prevent further scarring. The implant will be removed, as will the capsule around it. Your surgeon may place a temporary saline implant while the one that has been removed is thoroughly cleaned. Excess scar tissue is removed, and your surgeon may then replace the removed implant, or insert a new one altogether. The scar will be sutured shut with dissolvable stitches, and a dressing may be applied to keep the area clean.

The surgery can take between one and two hours, and you will need to stay in hospital overnight for observation. Your medical team will check for alignment and symmetry to ensure the implants have been re-inserted successfully, along with monitoring things like infection.

Recovery

You will not be able to drive home from your surgery, so you should arrange to have someone pick you up and take you home once you are clear to be discharged.

It is normal to feel bruising and pain following the procedure, so you may wish to have some paracetamol available during your recovery to manage this. You can also request prescription painkillers if you should need them. In the days following your surgery, you will need to rest and take it easy. Abstain from things like driving, heavy lifting and doing anything too strenuous, as this can cause your scarring to rupture, which can lead to possible infection. It is recommended that you wait until two weeks following your surgery to resume normal activities.

Your surgeon may suggest you perform massage on your breasts to alleviate swelling and stimulate blood flow. You may also want to invest in creams rich in Vitamin E to help minimise the look of your scarring. If you drink or smoke, abstaining from this as you recuperate should increase your rate of recovery. If you have any questions about any feelings or the appearance of your scarring, make sure you follow up with your surgeon directly straight away.


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What Are the Practicalities for the Patient?

You will need to stop smoking for at least two weeks before a capsulectomy. and stop taking any non-prescription drugs including natural remedies. It is best to avoid the surgery while you are menstruating so you do not get additional pain from your breasts swelling.

The surgery needs to be done under general anaesthetic and can take up to three hours. Normally you will need to stay in hospital overnight, but some facilities do it as day surgery. You will normally be able to return to work in a couple of days, but should avoid strenuous physical activity for one to two weeks.

Complications/Side Effects

Due to the invasive nature of the surgery, some risks can arise when you have a breast capsulectomy. During the surgery itself, you may be susceptible to infection, and you may have an allergic or adverse reaction to the anaesthetic. It’s important to divulge any information you have about known allergies prior to surgery to prevent this. There are the risks of pain, infection, bleeding and clotting that can accompany a capsulectomy, as is the case with any surgery.

Complications specific to a capsulectomy include loss of feeling in the nipple, while some patients note a loss of sensation. Although rare, there is the chance that nerve injury could occur at some point during the surgery. There is the possibility that there are problems with the implants too, which could hamper your recovery time and even potentially require more surgery. You may be unhappy with the new implants, and have issues with breast asymmetry. Finally, there is the chance that capsular contracture reoccurs, which would require undergoing the process again.

If you are at all unsure about the side-effects or feelings you have after surgery, make sure you discuss these with your surgeon as soon as possible to prevent further complications.

What Happens After Capsulectomy Surgery?

In the months following your capsulectomy surgery, you may find that your scars begin to gradually fade. While they will not disappear completely, using creams that contain healing oils or Vitamin E can help reduce the appearance of your scars. Some women have reported that a capsulectomy left them unable to breastfeed. If you have not yet had children, you may wish to discuss this potential repercussion with your surgeon before undergoing the procedure. You may have to wear a special bra during the first six weeks of your recovery as well. This will help to alleviate the pressure on your scars, and enable you to keep the area clean and dry. You may have difficulty washing during this time, and it’s important to keep your scars dry to lower the risk of infection.

Your surgeon may insist on regular follow up checks to ensure the implants have been re-inserted correctly, and that your recovery is going to plan. With plenty of rest, refraining from exercise and heavy lifting and taking your time to heal, you should be feeling recovered and back to normal in just a few months after your surgery.


What About the Costs?

The need for a breast capsulectomy operation occurs infrequently, with this type of complication arising in less than 6% of patients. However, if the surgery is required, it will be costly with prices ranging between £4,000-£7,000.

There are a number of factors that will determine how much the operation will cost, such as whether one or both breasts need treatment, and if the treatment will require replacing or just removal, and the type of implant used if replacement is necessary. Other cost-determining factors include the experience of the surgeon, and whether you opt for private treatment in a clinic. Although an expensive surgery, a breast capsulectomy operation should not be undertaken based on price considerations alone. This surgery should be carried out by a highly-experienced surgeon, and you should be careful to do your due diligence before making your selection. It is therefore a wise idea to speak to several surgeries and compare quotes before you commit to a breast capsulectomy surgery.

You may be able to qualify for finance to enable you to spread the cost of your procedure, which can alleviate money worries and help you focus on making the right decision with the best surgeon.

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