[Medical Column] Is it necessary to remove the capsule during revision breast surgery? (capsular contracture, infection, rupture)

 Is the capsule removal always necessary?

When an implant is inserted into the body during breast surgery or breast augmentation, our body recognizes this foreign substance and reacts to it. To separate our bodies from foreign substances and protect existing tissues, a protective shield is created to surround them.

This is a type of defense system that operates to keep itself safe. This protective film created at this time is called a ‘capsule’, and all breast implants inserted into the human body are surrounded by this ‘capsule’.

Occasionally, among patients who come for breast revision surgery consultations, there are those who think that the 'capsule' is unconditionally a bad tissue and that it must be removed during breast revision surgery, but the normally formed capsule is absolutely not a bad tissue.



normal capsule

However, if a problem occurs around the implant, such as bacterial infection or rupture of the implant, there is a high probability that there is a problem in the membrane, which is the first line of defense, that is directly in contact with the implant.


 




The problematic film becomes abnormally thick due to bacterial growth, and something like a lump may form.

The shell with this shape change can put pressure on the implant or move its position. If this condition persists, patients will experience symptoms such as 'abnormal sensation of touch', 'pain', and 'breast shape deformation', and this is what the breasts are like. The number one cause of reoperation is ‘capsular contracture’. Complete resection of this unhealthy capsule is essential during revision breast surgery .


 


You may have been surprised to see the scary film, but this is not a common case.

It occurs when the condition is left in a bad condition for a very long period of time, and this is a very unique case that I encountered as a person who has performed breast surgery for over 20 years.

Basically, I felt sorry that if I had undergone a safe surgery under sterile conditions, checked my condition periodically with the surgeon to see if there were any problems after the surgery, and taken the necessary treatment quickly when a problem occurred, it would not have ended up like this.

Most breast surgery side effects seem to occur through a similar mechanism. We are reminded once again that following the basics properly is the most important thing in safe and satisfactory surgery.

https://youtu.be/Gv8ApcAWgIU


If you would like to know more about whether or not to remove the capsule during re-operation, please check the video above.


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