Before and after bilateral breast implant revision in a 47-year-old woman with contracted and uncomfortable saline implants. They had been in place for twelve years, and she noticed after mastitis when she was breastfeeding that both breasts felt hard and had “points” in some places.
These protuberances are called implant “knuckles” and form when the implant folds on itself due to circumferential scar tissue formation in capsular contracture. Because she experienced pain, her contracture was classified as Grade IV.
Bilateral capsulectomy and implant exchange removed the old implants and reopened the pocket to be more symmetrical and large enough to accommodate a new implant. New smooth round silicone gel breast implants were placed in the subglandular position, on top of the muscle.
Whenever capsulectomy is being performed for capsular contracture, we sent a piece of scar tissue to the Microbiology lab at the hospital to look for bacteria. In this case, no bacteria were detected, which lessens the chance of recurrent contracture. If bacteria were detected, we also request sensitivity results and will treat our patients with two weeks of an antibiotic that is best directed to treat any residual bacteria.
Follow up photos are shown 7 months after surgery. She has soft, symmetrical, natural looking and feeling breasts without any evidence of capsular contracture recurrence.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
