Patient Questions

QUESTION

Thoughts about Putting Back the Same Implant After Capsulectomy?

I had Brachioplasty surgery and a Breast Lift with implants this past Septemeber. My right breast now has a painful Grade IV contracture resulting from a hematoma. To make matters worse, the particular model of Mentor cohesive gel implants that I got are not yet approved in the US. My local surgeon wants to perform a capsulectomy and replace with the SAME implant. I mentioned to him that everything I read indicated standard practice was to replace with a new implant. He said that I would be fine since I hadn't had the implant in very long. I am very indebted to him because he was willing to consult with me when other surgeons blasted me for going overseas. They could care less that I had lost 169 lbs and had debilitating excess skin. My Costa Rica surgeon told me to come back so he can perform the capsulectomy and replace it with a new implant, however, I'd like to avoid travelling back to Costa Rica if at all possible. What should I do at this point? Any advice would be helpful! I am almost positive this hematoma occurred as a result of strain and is not ruptured. Should I be leery of my US surgeon wanting to replace with the SAME implant?

ANSWER

Replacing breast implants

Any surgery around an intact implant where the end result includes having an intact implant in place should have implants available. In my practice we believe that a major cause of capsular contracture (hard or firm breast implants) comes from subclinical bacterial contamination. To reduce the possibility of this happening again, we would recommend the implants being replaced (the biofilm on the old implants may be impossible to sterilize). That is not to say that re-using the old implant is improper, but in our experience, it may increase the possibility of recurrent capsular contracture. To answer your new questions - mixing the implants (as long as they are both silicone for consistent feel) should be ok. Be sure to remember that the sides may feel different even if the same implant is used because of the additional surgery on the breast with the capsular contracture. Depending on the extent of the capsulectomy - your old implant may not be enough to give you symmetry. Be sure to discuss all these issues with your surgeon before your surgery.

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