Do You Need A Breast Implant Capsulectomy Or Not?

By: Dr. J. Timothy Katzen


Breast augmentation is a common plastic surgery procedure and is achieved by inserting sterile saline or silicone implants in the breast. However, every good thing has a downside. There is a condition called Capsular contracture. Capsular contracture is a completely natural phenomenon. When your body is exposed to anything foregin, your body walls off the offending cause with scar. Scarring around a breast implant is completely normal. In the case of scarring around a breast implant, the scar is like an egg-shell or capsule. Also, all scar tissue contracts in an effort to eject the foreign body. Thus the term “ capsular contracture” is used to describe scar tissue around a breast implant.

Now, it may seem like our body is trying to protect us through this condition, so how can it be wrong? Well, to answer your question, the scar tissue causes hardening in the breast area, which can be significantly painful. One major issue is that there is no way to predict when capsular contracture will take place and on which side of the breast.

If you have a scar, hardening, or thickness in your breast, after breast implant insertion, it may be time to have the capsule removed. You might be wondering how it will solve the problems, how it’s done, and when it can take place. Well, we are here to answer all your questions.

What is Breast Implant Capsulectomy?

Unfortunately, breast implant capsulectomy is a common plastic surgery. The procedure removes scars or capsules that have hardened or thickened around the breast implant. The capsule formation is normal after breast surgery, and when it contracts or becomes thick, the plant can get distorted and cause pain in that area. The condition that results from it is called Capsular contracture. It takes place after breast implant augmentation surgery.

Research shows that about one and six breast augmentation patients experience some degree of capsule contracture. Generally, breast implant capsular contracture occurs during the healing process. Approximately 75% of all capsular contractures around a breast implant will occur within two years of the breast implants being placed. To determine the severity of breast implant capsule contracture, a classification system was created. This classification system was created to allow objective analysis amongst medical personnel to describe the severity of the breast capsular contracture. This classification system was created by a very famous plastic surgeon, Dr. Baker. Therefore, this is called the Baker classification system.

Baker Class I breast implant capsular contracture: these patients are without symptoms The formation of scar tissue around the breast implant does not interfere with the size, shape, or texture of the breast. The breast look natural and remain soft to touch.

Baker Class II breast implant capsular contracture: these patients have minor cosmetic symptoms. The breasts usually appear normal in shape, but feels somewhat firm to touch.

Baker Class III breast implant capsular contracture: these patients have obvious cosmetic symptoms. The breast will be firm to touch and appear abnormal. The breast may be overly round, hard looking and the nipples maybe misshapen. However, most of these patients don’t have much pain.

Baker Class IV breast implant capsular contracture: these patients have hard, misshapen, and a painful breast. The breast will feel tender and painful to touch.

What Causes Capsular Contracture?

As previously mentioned, there is no way to determine where scar tissue will form or how the body will heal.. Although there are a few pieces of research that have indicated the type of breast implant that can cause this medical condition, studies suggest saline implants placed above the muscle have a higher incidence of capsular contracture compared to silicone implants placed above the muscle.

There are several other theories which increase your risk of capsular contracture. Some patients are genetically inclined to form excess scar tissue. These are patients with autoimmune diseases. Another theory is that a “biofilm” is created around the breast implant and leads to capsular contracture. A biofilm is a thin layer of bacteria that develops around the breast implant after the implant is introduced into the breast cavity during surgery. The bacteria can cause chronic, low-grade infections and can produce fever and fatigue. Other conditions include blood clots and collections of fluid (seromas) that develop in your healing process. Both conditions can increase the source of nutrients which can increase bacterial infections and thus, creation of a biofilm.

Preventive Measures

Being a member of the healthcare community, it is Dr. Katzen’s duty to recommend different choices that you can undertake to reduce your chances of developing capsular contracture.. Here is what Dr. Katzen suggest:

Ways to decrease breast implant capsular contracture:

You and Dr Katzen are a team in your breast augmentation journey. As part of the team, both of you need to follow the following rules to minimize capsular contracture.

1) Stop smoking. Smoking increases hematoma formation and impairs healing.

2) Do not choose an implant that is too large for your breast skin.

3) Choose that your breast implant be placed underneath the muscle.

4) Perform postoperative breast implant massages to minimize capsule contracture.

5) Avoid oral procedures for three months after your breast augmentation. This prevents bacteria from spreading in your bloodstream.

During your breast implant surgery, Dr.Katzen will also do special techniques to minimize capsular contracture. Dr.Katzen will minimally handle your breast implant and thoroughly irrigate the breast pocket with Betadine and antibiotics. These maneuvers have been shown to decrease the chances of breast implant capsular contracture.

Is breast capsulectomy covered by insurance?

Yes, often breast implant capsulectomy is covered by your medical insurance. Typically, patients need to have a Baker 3 or Baker 4 breast implant capsular contracture for insurance approval. Often, if you have breast pain due to the breast implant capsule that interferes with daily activities, a capsulectomy may be covered by your medical insurance.

What happens during the capsulectomy?

A breast implant capsulectomy is performed under general anesthesia with a board certified anesthesiologist. During a breast implant capsulectomy, an incision is made on the breast skin. You and Dr.Katzen will decide where the incision is to be placed. Then, tissue dissection is carried to the scar around the breast implant or breast capsule. During a capsulectomy, the breast capsule is removed. Sometimes, the entire capsule is removed. This is called a “complete or total capsulectomy.”. Sometimes, the back wall of the capsule (the part of the capsule or scar tissue that is against your rib cage), is left in place. Often, this back wall of the capsule is left in place due to the potential risk in entering the lungs during the surgery. Therefore, the benefit of removing the back wall of the capsule does not outweigh the risk involved in potentially puncturing the lung. Therefore, this is called a “partial capsulectomy.“. Sometimes, the capsule is entered, the breast implant is removed and then the capsule is removed. Sometimes, the capsule is not entered in the entire capsule and breast implant is removed as one specimen. This is termed an “en bloc” capsulectomy.



Schedule A Consultation Session Today!

If you are looking for a certified and expert plastic surgeon, Dr. Timothy Katzen should be your number one choice. Given his experience in reconstructive surgeries and body aesthetics, there is no denying he should be your prime choice. Dr. Timothy Katzen is a plastic surgeon well known in Beverly Hills, CA, Las Vegas, NV, and Dubai. Dr. Katzen is an experienced plastic surgeon ready to listen to your concerns and create your new dream breast implants. Call Dr. Katzen today to schedule your FREE breast implant consultation and see if you need a capsulectomy. For your convenience, Dr. Katzen has offices in Beverly Hills, CA, Las Vegas, NV, and Dubai. If distance and traffic are a problem, virtual consultations can be scheduled through FaceTime, Skype, WhatsApp, or Zoom. Call (310) 859-7770 today, to get the breasts you deserve.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.