En Bloc Capsulectomy and Breast Lift at age 78, Raleigh, NC
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This 78 year old woman had a history of breast implants placed in the 1980's. She developed a rupture of one side 20 years later and had a replacement with a Siltex silicone gel implant after capsulectomy and implant removal. She developed a capsular contracture on both sides. This was firm and somewhat uncomfortable but she lived with it. It became worse with pain, distortion and firmness . 14 years after her implants were placed, she had them removed and a mastopexy performed. At surgery, she had an en bloc technique. This is performed to remove the implant and capsule together. It is not always necessary but with her textured devices and firm capsule- it was completed without undue damage to surrounding structures. She had thickened capsules and an unexpected old hematoma in the right side. Testing for ALCL was performed and it was negative. Textured implants were designed to reduce capsular contracture. They are now under scrutiny because of a their association with a rare form of lymphoma -ALCL that can occur in the capsule. It is heralded most often by sudden swelling in a breast implant and sometimes a mass. It usually occurs at least 7-8 years post implantation. Although rarely fatal, it can be so- removal of the implant and capsule is necessary. Siltex implants have not been recalled because they are not as common in reported cases. Decisions about degree of capsulectomy, whether a lift is beneficial should be discussed with your plastic surgeon .