Capsular Contracture Archives | La Jolla, San Diego | Tim Sayed, MD, FACS
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How to Evaluate an En Bloc Breast Implant Removal Surgeon

When a breast implant is placed into the breast, the body creates a capsule of scar tissue around it. Much of the time, this capsule will remain soft and malleable. If your implant ruptures, the capsule can hold the leakage in place, keeping it from escaping into the body.  This capsule is a good thing and helps protect your body and your implants. Capsules form anytime a foreign object is placed into the body; it is a natural form of protection your body uses to stay safe. 

Sometimes, the capsule will contract or harden, a condition known as capsular contracture. When this occurs, the breast may feel harder or the implant may become distorted. Capsular contracture can be uncomfortable. To treat it, we perform a procedure called en bloc breast implant removal. The implant and its surrounding capsule are removed together, with the capsule remaining intact. After the implant and capsule are removed, we can replace your breast implant with a new one. En bloc removal offers benefits when an implant has leaked or ruptured too, as it can help contain the leakage and protect the body.

Does Your Surgeon Have the Qualifications?

En bloc removal is a complex procedure, one that many surgeons don’t have the skill set to perform well. En bloc means as a whole, and in this specialized type of implant removal, the implant and capsule are removed in one unit. 

We like to think of the capsule surrounding your implant as a balloon. It is made of scar tissue, but it is delicate and easy to open. This scar-tissue balloon must be carefully separated from your breast tissues and removed through the inframammary incision created for the procedure. This precise dissection is a skill that must be honed through practice and training. If the capsule is opened, the biofilm, implant leakage, or bacteria can seep into the breast, potentially causing complications. 

Removal is often only the first step. If you’re hoping to remove and replace your implants, you’ll need a surgeon skilled in breast augmentation. If you’re not planning to replace your breast implants, you’ll need a surgeon that can carefully reconstruct your breast shape so it doesn’t look saggy or deflated. 

Look for these qualifications when choosing a surgeon for your procedure:

  • Specializes in breast surgery
  • Performs en bloc removal often
  • Board-certified plastic surgeon
  • Known for their precision and attention to detail

Dr. Sayed meets these qualifications and more. If you’re in the San Diego area, come in for a consultation to discuss your breast implant removal in more detail.

Do I Need En Bloc Breast Implant Removal?

En bloc implant removal isn’t always needed, but it can be beneficial to many patients, especially those experiencing complications with their breast implants. Removing the whole capsule keeps fluids, leaks, and biofilm contained, reducing the risk of future complications when new implants are placed. 

En bloc removal is recommended if:

  • You have capsular contracture
  • Your implant has a leak or rupture
  • You want to change your implant type or size
  • Your breast implants were placed many years ago
  • You want to remove and not replace your breast implants
  • You have implant rippling or distortion
  • You’re experiencing health complications that require breast implant removal

If you’re considering en bloc breast implant removal in San Diego, come in for a consultation with Dr. Tim Sayed. Contact our office at 1-858-24SAYED to schedule your consultation or learn more.

Capsular Contraction Corrections: Which Choice Is Best for You?

Regardless of the skill of your plastic surgeon or how perfectly your implant surgery goes, there is a small chance that complications may arise during or after the procedure. Everybody is unique, and each person’s breast tissue heals and accustoms to foreign objects differently.

From the same surgery, some patients may only see subtle scarring that fades over time while others can develop thick scar tissue. Complications are very rare thanks to the modern advances in surgical techniques, and surgeons’ have developed increased abilities to predict which patients have a higher likelihood of experiencing any complications.

However, a small percentage (under 10 percent worldwide) of women may begin to develop capsular contraction. A natural bodily response to the implant procedure, contracture can progress through four stages if left untreated (though the later stages are incredibly rare). At each “grade” of contracture, you have options to reverse any discomfort and get great-looking results. Dr. Sayed offers several treatments to fit your unique circumstances.

Read on to learn more about which is right for you. If you have any further questions, please don’t hesitate to give our San Diego, CA, office a call today at 1-858-247-2933.

Non-invasive Options for Treating Early Stages of Contracture

Initially, after surgery, several options can treat any early complications and improve implant appearance. Two of the most effective are self-massage and ultrasound therapy. 

Self-Massage

Massaging your breasts as they heal can prevent capsular contracture, as it encourages breast tissue to remain pliable.  However, it is essential to get permission and guidance from Dr. Sayed before massaging your implants. This ensures you conduct self-massage properly so you will not disturb the tissue of your breasts as they heal from surgery, possibly damaging the tissue inadvertently and making capsular contracture more likely.

Ultrasound Therapy

Ultrasound Therapy has been one of the most popular and successful advances in treating early stages of capsular contraction. It is entirely non-invasive, pain-free, and does not increase the risk of capsular contracture in the future.

During the procedure, a special device utilizes precise ultrasound waves to encourage healthy collagen grown. This therapy increases elasticity around the implant and within the breasts, to make them feel more soft and pliable.

Generally, the therapy is completed over two or three weeks in combination with antibiotics to target capsular contracture’s root cause. Studies have shown ultrasound therapy to be effective in treating and reversing grade two and grade three cases of capsular contracture.

Treating Advanced Capsular Contracture

For patients who develop more advanced cases of capsular contracture (grade three or four), surgical interventions may be required. Here are the most effective options available:

Capsulectomy

A capsulectomy is complete or partial removal of the affected implant as well as the surrounding capsule. Dr. Sayed will replace the implant during capsulectomy to avoid any chance of contamination and infection.

In some cases, changing the implant pocket location may decrease contracture. For instance, if your implant was previously beneath the chest muscle, the new implant may be placed above the muscle to lower the chance of recurrence.

Capsulotomy

During a capsulotomy, Dr. Sayed will score or otherwise partially release the capsule, allowing the implant to better settle. In most cases, Dr. Sayed will make an incision into the capsule and perhaps remove some of it. Some patients require an implant replacement during capsulotomy, in which case Dr. Sayed will remove and replace your existing implant.

Implant and Capsule Removal Without Replacement of the Implant

While most clients wish to save their augmentation in the case of capsular contracture, some opt to remove their implants and capsule entirely without replacement. This procedure is known as en bloc breast implant removal and is one of the safest and most proven ways to reverse grade four capsular contracture.

Once Dr. Sayed has completed this procedure, you will be able to undergo a new augmentation process with a healthier pocket. This is a specialized surgery, and not every surgeon can offer excellent results. Dr. Sayed has particular expertise in breast anatomy and surgery and will work to give you the best possible outcome.

Schedule a Consultation

If you have any concerns about capsular contracture or would like to discuss the particulars of your situation, please call our San Diego, CA, office at 1-858-247-2933, or schedule a consultation online.

Dr. Sayed is a board-certified plastic surgeon and has a high success record in the correction and improvement of capsular contracture.

Top 10 Questions to Ask Your Capsular Contraction Correction Surgeon

Breast hardening, distortion, and pain are all symptoms of capsular contracture, a breast augmentation complication. While improvements in breast augmentation technique have reduced the risk of capsular contracture, the condition still occurs in a small number of implant patients. Women who develop the characteristic asymmetry or implant distortion usually must undergo corrective surgery to remove the capsule and reposition or replace the implant.

Although the prospect of additional surgical treatment may seem invasive, visiting an experienced plastic surgeon can ensure you receive the best care possible. A skilled plastic surgeon can correct the deformities and discomfort and restore the breast’s appearance.

Questions are a must. Asking plenty of questions during your initial consultation can help ensure that you are fully aware of what corrective treatment looks like for your unique situation.

Be sure to bring these top 10 questions to your consultation visit and for additional questions, contact our San Diego plastic surgeon.

  1. How Severe Is My Capsular Contracture?

Capsular contraction correction is determined based on the extent of the contraction. During your visit, your surgeon will evaluate and classify your symptoms according to the Baker classification – a grading system that categorizes symptoms in grades from one to four. Baker Grade 1 classification is the most minor form of capsular contraction. At this stage, contraction is imperceptible. Grade 4 contractures are characterized by an abnormal-looking breast accompanied by painful hardening.

  1. What Are My Treatment Options?

There are many treatment options for capsular contracture. These include:

  • Capsulectomy- Removal of the capsule and removal and replacement of the breast implant.
  • Capsulotomy- Scoring or partially releasing the capsule.
  • Implant Exchange- Implant is removed and replaced with a new breast implant.
  • Implant and Capsule Removal Without Replacement
  • Ultrasound and Massage

Your surgeon will outline the treatment options that are available to you.

  1. Do All Corrective Treatments Require Surgery?

Not all capsular contracture patients will require going under the knife again. In some early and mild cases of contracture, a specialist may recommend non-invasive ultrasound and massage therapy to alleviate pain and reduce contraction risks.

Surgery is often required for effective treatment but talk with your plastic surgeon to discover all available options.

  1. How Will My Implant Placement Influence Surgery?

Capsular contracture is less likely when a breast implant is placed under the chest muscle. When treating this condition, your surgeon may recommend changing your implant placement to reduce the risk of recurrence.

  1. Have You Treated Patients with Similar Forms of Capsular Contracture?

As with choosing the right breast implant doctor, finding the best surgeon for breast revision treatment is vital to achieving natural-looking results. In Newport Beach and La Jolla, Dr. Sayed is happy to help patients by providing a second opinion regarding their capsular contracture. He regularly treats this condition and has high levels of success.

  1. What Are the Warning Signs of Worsening Capsular Contracture?

Capsular contracture may not develop for several months following initial breast augmentation surgery. The most noticeable signs to watch out for are soft breasts becoming firmer or rounder, excessive bleeding around the incision site and chronic pain around the breasts.

  1. How Can I Prepare for Surgery?

Preparing for corrective surgery is similar to other breast surgery procedures. Patients first undergo an extensive evaluation during which a skilled surgeon will identify the best surgical approach. In the weeks leading up to surgery, patients will be advised to stop smoking. Your doctor may recommend vitamins, supplements, and other preparations.

  1. How Long Is Recovery After Capsular Contracture Correction?

Following corrective surgery, we recommend patients give themselves several days of recovery before heading back to work and avoid strenuous activity for two to six weeks following surgery. During your consultation, your specialist will provide you with a personalized recovery timeline.

Your recovery timeline will depend on the techniques used for your correction.

  1. Is it Safe to Replace Implants After Corrective Surgery?

Yes, so long as you don’t use the same implants. During your consultation, your plastic surgeon can help you identify the right implant type and how to reduce your risk of future contracture.

Dr. Sayed uses specialized protocols to reduce capsular contracture risk including antibiotics in the breast implant pocket, special handling of the implants, a Keller funnel, and a no-touch technique on the skin.

  1. What Is the Likelihood of Recurrence?

While initial capsular contracture is relatively rare, recurrent contracture is high. If a surgeon is not diligent and fails to remove all signs of biofilm or bacteria, patients may end up with capsular contracture again.

Choosing a skilled breast surgeon with experience treating capsular contracture is essential to reduce this risk.

Bring Your Questions to Dr. Sayed

To learn more about correcting capsular contracture, call 858-247-2933 and schedule your consultation with our plastic surgeon.