Patient 326 Gallery

Before and after bilateral explantation under local anesthesia in a 47-year-old woman. Her submuscular implants had recurrent capsular contracture, and she had undergone five prior surgeries, always hoping that the next surgery would “fix her problem.” The placement of the implants under the muscle caused them to be spaced widely and created chest muscle spasms every time she used her arms.

She was “so over them” and just wanted her implants out. Other than the hard feeling of her breasts and the abnormal displacement of the implants upward (superior malposition, worse on her right dominant side), she did not have any pain.

She did not want a big surgery with a long recovery and elected to have her implants removed through a new incision in the natural fold of her breasts. This is our preferred incision to insert implants in the first place, as it is associated with the lowest complication risk. Local anesthetic was injected as she breathed inhaled laughing gas and had an anti-anxiety pill on board. Her implants were removed and were photographed on the back table.

Since she had capsular contracture several times, a postage stamp-sized piece of scar tissue from the internal capsule was sent to the Microbiology lab for assessment – it did not show any active bacteria. Bacterial contamination is thought to be a primary cause of capsular contracture, based on the “biofilm theory.”

She was allowed to inspect (even touch) her implants before they were discarded in medical waste by the Pacific Professional Building (it is the law – you cannot take your explanted medical devices home with you). Her incision was closed with several layers of dissolving sutures. She showered in 48 hours and resumed exercise in two weeks.

Early follow up photos are shown 10 weeks after surgery. Her breasts are continuing to contract and assume their normal size and shape, and she is beginning to apply scar gel. Her scars will mature and fade over the next year.