When having a capsulectomy and replacing implants, how much breast tissue is lost?

Q:

If you have silicone implants and are having a capsulectomy, also replacing the implants with new ones, how much if any breast tissue is taken out and how long does this surgery take?  Would a mammogram tell if breast tissue has to be removed with the capsulectomy?  I am already small breasted and have heard that sometimes breast tissue is removed during the procedure.  Will a mammogram tell how much tissue would need to be removed?  How much time will I be in the operating room for the surgery?

A:

If the implants are under the muscle then no breast tissue is removed when doing a capsulectomy.

If the implants are above the muscle, very little fat (No breast Tissue) is removed.

Using the HARMONIC SCALPEL will decrease the chance of removing much fat.

Doing enblock removal of capsule and implant in case of implant rupture will need a longer scar.

A:

The idea of a capsulectomy is to only remove the abnormally thickened capsule tissue, and not normal breast tissue, if possible.  That being said, capsules vary - some are quite thick, and so 30-50 cc's of tissue volume might be removed, and a little bit of breast tissue might incidentally come out with the capsule.  The time to perform the procedure varies with how easily the tissue separates from the surrounding normal tissue, but plan on about 2 to 2.5  hours for a capsulectomy and exchange.

Best of luck!

 

Thomas G. S. Fiala, M.D.M.D., F.R.C.S., F.A.C.S. - View Other Answers by this Doctor
Altamonte Springs, FL

A:

It would be uncommon to remove very much breast issue with a capsulectomy.  If there is a problem with capsular contracture and tissue is extremely adherent or the implants are ruptured and are being removed for that purpose, then there is more of a chance for removal of breast tissue with the capsulectomy.

A:

The goal when performing a complete capsulectomy is to remove as little breast tissue as possible and all of the scar tissue capsule.  However there is a small amount of breast tissue that is adherent to the capsule that is removed inadvertently.  This amount is no where near a cup size, probably around 10-20 grams maximally.  A mammogram will not help in determining  how much breast tissue will need to be removed.  Generally a total capsulectomy with removal of breast implants and then replacement with new implants takes around 2 - 2 1/2 hours.  Your plastic surgeon will review all this information when you have your consultation.

A:

Our goal is to remove as little breast tissue as possible with a capsulectomy whether it be above or below the muscle.  In general an imaging study such as a mammogram will be helpful in knowing if breast tissue will need to be removed.  The duration of the operation will vary. Your plastic surgeon should be able to give you a ball park idea of how long your procedure will take.

I wish you well.

Dr. Edwards

A:

During capsulectomy every attempt is made to remove only the breast capsule and implant.  In very severe extreme a capsular contraction often in patients with ruptured implants the capsular tissue can be adherent to breast and fat surrounding the capsule and small amounts of fat or breast tissue can inadvertently be removed.  However this is usually not noticeable especially when new implants are being placed.

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