-A capsulectomy is removal of all the scar tissue from around the implant.
-An En bloc capsulectomy is used to describe removal of the implant with the intact capsule still around it.
-A capsulotomy is partial removal of the capsule and opening of the capsule.
A capsule is scar tissue that has formed around an implant. This is your body’s normal reaction to having something foreign in it. Every patient with an implant has some capsule, which is quite normal and expected. Your body will form a capsule around any implanted device and does so around breast implants, artificial joints, and even pacemakers.
A capsular contracture is when the scar tissue around the implant becomes tight and deforming to the implant.
The majority of patients who have had breast implants over 5 years will have some amount of loose skin. How much that will bother the patient is very different from patient to patient. Dr. Rai can discuss if he would recommend a breast lift for you. It can be done at the same time safely and therefore would limit the need for a second operation.
Fat grafting is a good tool to fill out certain areas of the breasts. In general, fat grafting will never replace the volume of the implant. It is good for filling certain areas (the upper part of the breast) and trying to correct some depressions. Dr. Rai ideally prefers to stage this operation 3 months after your initial explant but it can be done at the same time if the patient desires.
This depends on many factors such as the patient’s age, the size of the implant, how long ago the implants were placed, how much loose skin is present, and how much natural breast tissue is left. The biggest factor seems to be the amount of natural breast tissue and how long the implants have been in place. Certainly, where patients will notice the difference the most is in the upper pole of the breasts. This is where the implant is providing fullness and this is the most noticeable area where you will lose volume after explanation.
Absolutely! A lot of patients have secondary cosmetic procedures done at the same time as breast implant removal. This includes but is not limited to liposuction, tummy tucks, and facial procedures. All can be done at the same surgical setting and generally don’t add to the recovery time.
Most insurance companies have exclusions for any procedure involving implants that were placed for cosmetic reasons. Implant removal can be covered if it is after reconstruction for breast cancer, a significant grade IV capsular contracture (deforming breast), or rarely a proven ruptured silicone implant. Dr. Rai is not an in network provider with any insurance and does not file with insurance for any surgical procedures
Fluffing is a word used by a lot of women to describe softening and smoothing of the breasts after surgery. This is a very normal reaction after every surgery. Immediately after surgery the breast tissue is tight and firm due to edema or fluid in the soft tissue. After several weeks the fluid leaves the tissue and the breasts begin to soften and smooth out. The breasts will change significantly for the first several months after surgery. Cupping are devices some ladies choose to use to try to get the breasts to fill out a little more.
Breast Implant Illness is a term used to describe breast implant patients who have been suffering from various symptoms including but not limited to joint pain, muscle pain, fatigue, brain fog, thinning of hair, migraines, nerve pain, and memory loss. Often these patients have seen many different doctors and had many different tests without being able to identify any specific cause of the symptoms. These patients are concerned the implants could be contributing to or causing these issues and often this is the reason for wanting to remove the implants and capsules.
Leaks in saline implants are easily detected because the body re-absorbs the saline fluid and the breast is noticeably smaller in size. With silicone implants it is much harder to tell if there is a rupture. The gold standard for detecting a ruptured silicone implant is an MRI. Even on physical exam it is difficult to tell as the silicone usually is still contained within the scar capsule around it.