"(Age 35 -mother of 3) I’ve had 3 breast surgeries for implant capsular contracture. I developed a cap again after my 3rd surgery. I have lived with this for 6 years and want to correct this. The implants are silicone and over the muscle. In addition to resolving cap, I would like to address side rippling, nipple re-symmetry, and cleavage too far apart. My other concern is that I am naturally muscular and I’m afraid of going under the muscle may cause movement of the implant with muscle contraction."


DR. POUSTI: Recommendation for breast implant replacement after capsular contracture.

I am sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons. In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants and the use of acellular dermal matrix. Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin).

You are correct in that sub muscular position conversion may lead to some breast implant movement when your pec major contracts, but this is not a major concern or nuisance for most patients who undergo breast surgery; the potential upside (avoidance of recurrence of encapsulation in your case) is worth this trade-off.

I hope this, and the attached link (demonstrating a case utilizing acellular dermal matrix) helps.

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