FAQS About Breast Capsulectomy

Who should consider breast capsulectomy surgery?

If you have developed capsular contracture then you will require this surgery. Capsular contracture is where the capsule surrounding the breast implants tightens, which can cause pain or a misshapen breast.
This scar tissue or capsule is a normal bodily response but become s problem if it thickens over a period of time. This thickening increases to the point where it contracts hence the name capsular contracture. It becomes hard and round which affects the shape of the implant. It can become so thick that you can actually feel the wall of scar tissue.
There are four types of capsular contracture which are allocated a ‘Baker grading’. These are:

• Grade 1 – the breast appears to be as normal (soft and natural looking).
• Grade 2 – the breast is normal looking but it is a little firm.
• Grade 3 – the breast looks abnormal and firm to the touch.
• Grade 4 – the worst case scenario. The breast is rigid, firm and looks abnormal. 

Can breast capsulectomy surgery be prevented?

This is always a risk but there are certain things you can do to reduce the risk. These are:

• Post-surgery massage. It is a good idea to massage the breasts but it is only recommended for those women who have had smooth implants. See the ‘breast implant’ section ( ) on the different types of implants.
• Wear a compression bra. This works well especially if combined with compression exercises.
• Take Vitamin E (orally). This vitamin improves the skin and so may do the same with scar tissue.
• Choose textured implants which prevent hard capsules from forming.
• Take a specific nutritional supplement but check with your surgeon first.

Who is not suitable for breast capsulectomy surgery?

If you are under 18 then you may be considered too young for this procedure. However, exceptions are made for girls aged 16 or 17 and you may be one of these. Your age and your reasons for this surgery will be discussed with your surgeon.

What do I have to do before breast capsulectomy surgery?

If you are satisfied with everything your surgeon has told you and have agreed to surgery you will then have to prepare for this surgery.
This will be familiar to you as you have undergone cosmetic surgery before. If you need to refresh your memory then have a look at our Breast Augmentation FAQs section. As this problem is linked to breast augmentation then this is a good place for that information.
That section contains advice on what preparations you need to do beforehand. This includes asking someone to help you during your first few days at home, arranging time off work, ensuring you have enough painkillers and medications (if required) and what to do if something goes wrong.
If you smoke then you will have to stop two weeks before surgery. You will also have to refrain from smoking for at least two weeks after surgery. It would be better if you could stop altogether and if you need any help with this then your surgeon can recommend a smoking cessation programmed.
We do recognize that this can be difficult and takes time so as long as you can manage not to smoke either before or after, then that will help. You will also find that your surgeon will not perform this procedure if you are still smoking.
If you have any allergies then it is important that you mention these. Your surgeon will take a full medical history so please be honest with this.
If you are taking any non-prescriptive medicine such as vitamin supplements, ginseng, evening primrose oil or garlic then you will have to stop taking these. There is evidence to show that these can interfere with the healing process.
If you are taking any prescribed medicine then also mentions these.

What is the breast capsulectomy surgery procedure?

There are two types of surgery: total capsulectomy and sub-total capsulectomy. In the first type, the whole of the capsule is removed and the breast implant is replaced with a new one. The sub-total capsulectomy involves the partial removal of the capsule, but only if the implant has not broken or moved. Either way, the implant will probably be removed. The idea is to remove the troublesome capsule and insert a new implant which will last longer than the previous one. Your surgeon has several options open to him/her regarding the incision and positioning of the implant. This will depend on your body type and personal recommendations. Your surgeon will break open the scar tissue of the capsule which releases the tension, and remove this.  He/she will then make an incision is either the crease underneath the breast, the armpit or the edge of the areola. This is where the new implant will be inserted.
The incisions are then closed with fine stitches which are either dissolvable or non-dissolvable ones. He/she will place tapes over the stitches for additional support. A light dressing will also be put in place.
This surgery takes around 1.5 hours to 3 hours to perform and is usually done under a general anesthetic. It usually means an overnight stay in hospital although in some cases, it can be done as day surgery. It is more complex than breast augmentation surgery.
Be aware that there is always the risk of this hardening occurring again.

What will happen after my breast capsulectomy surgery?

You will be taken to a recovery room following your surgery. Your progress will be carefully monitored by highly trained medical staff which includes checking your pulse and heart rate at regular intervals. As soon as they are happy with your condition you will be taken back to your room.
Once there a nurse will check your blood pressure and other vital signs. He/she will also check the condition of your surgical wounds. Surgical drains (small tubes) may still be in place. Don’t worry, these are temporary only and are only there to remove excess fluids.
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.
Your breasts will feel sore and bruised. 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. Do not drive, operate any machinery or make any important decisions during that time.
You will have some pain but this can be controlled with pain medication.
You will have to wear a special bra for a couple of weeks. You will also have to keep the dressings in place for that time. Make sure they do not get wet. After a couple of weeks, the wounds will be checked and cleaned but until that time, ensure that the dressings stay dry.
There will be scarring and these will have a firm, pink appearance for the next six weeks. Bear in mind that these will stay the same size for several months. It could be two years before they completely fade.
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 can return to work after a couple of days.
Do not undertake any sports or other physical activities for at least 7 to 10 days. You are looking, on average, at two weeks for a full recovery.

What are the benefits of breast capsulectomy surgery?

The main benefits are release of the unpleasant constriction of the breast implant caused by the capsules. Plus, the insertion of a new implant to replace the affected one will ensure a more natural looking appearance.
You will feel more confident and self-assured about your appearance. The breasts will be softer and more natural looking.
As will all cosmetic surgery makes sure you have realistic.

What are the risks of breast capsulectomy surgery?

No surgery is without its risks. This procedure is safe but complications do happen. The main one is the reforming of capsules around the new implants. Capsules are a normal bodily reaction when confronted by a ‘foreign body’ but the danger is that they will increase in size to the point that they constrict or damage the implant.
Other risks include:

• Infection
• Bleeding
• A bad reaction to anesthesia
• A loss of or reduced nipple sensitivity
• Ability to breastfeed is lost or affected
• Capsular contracture could re-occur
• Blood clots
• Nerve injury
• Breast asymmetry
• Problems with the implants themselves, e.g. wrinkling or deflation
• Nipple oversensitivity or under sensitivity
• Shortness of breath or a rapid heartbeat
• Sudden increase in pain

How long does breast capsulectomy surgery last?

This will last for a long period of time. Keep in mind though that capsules always form around breast implants and as long as they do not show any abnormal growth then you will be fine.
There is always the risk of them hardening and thickening but this is much rarer than it used to be.
Breast implants tend to last for around ten years or so you may require further surgery to replace these.