Capsulectomy is the common name for capsule removal following the development of problematic capsular contracture around a breast implant. Capsular contracture occurs when the natural tissue surrounding the implant shrinks and constricts, causing visual deformity, excessive firmness and even pain. Exactly why some patients develop capsular contracture is not definitively known, although many contributing factors have been tentatively identified.
There are two types of surgery to address the capsule: total capsulectomy and sub-total (partial) capsulectomy. In the first type, the entire capsule is removed. Sub-total capsulectomy involves partial removal of the capsule and can be performed only if the implant is not leaking or ruptured.
The operation involves opening the breast via a surgical incision. Choice of incision and positioning of the implants depend on your body type and aesthetic goals. This will be discussed with you prior to surgery. Capsule of scar tissue surrounding the implant is removed. Most commonly, the entire capsule is removed to eliminate the chance of a recurrence. Implants are either changed and implant placement revised, or implants are removed altogether. The incisions are then closed with fine stitches which are dissolvable and do not require removal. A light dressing is placed. Surgical drains (small tubes) will be placed to remove excess blood or fluid and prevent collections.
Surgery takes around 1.5 hours to 3 hours, depending on the surgical plan, and is usually performed under general anesthetic. It usually means an overnight stay in hospital although in some cases, it can be done as a day case.
After the surgery, you will be encouraged to get up and move around as soon as you can. This is to prevent blood clots forming in the legs which can be dangerous. You will be tired and out of sorts which is a normal reaction to surgery. A general anesthetic can make you feel groggy, nauseous and disorientated for up to 48 hours. You will have some pain but this can be controlled with pain medication. You will be requested to wear a supportive bra for 2 months.
You will have dressings for several weeks. Make sure they do not get wet. After a week, the wounds will be checked and cleaned. You will have to attend a series of regular follow up visits to check on your progress. These are to ensure that there are no complications such as infections or formation of new capsules.
As with other forms of surgery you need to avoid any unnecessary bending, stretching or physical activity. You should get plenty of rest, although you may be able to do some light activities after a couple of days. You will be asked not to drive for 10-14 days.
You can return to work after a couple of weeks, depending on your job. Do not undertake any sports or other physical activities for at least 6 to 8 weeks. Any sexual activity should be avoided for a minimum of one week, and your plastic surgeon may advise you to wait longer.
Your scars will be firm and pink for a few months. It could be 12-18 months before they completely fade. It is very important to follow the scar management regimen prescribed by Dr. Grubnik to ensure the scars fade well.