Enbloc Capsulectomy and Mastopexy of Textured Implants, Raleigh, NC*

This 53 year old woman had prior breast augmentation performed in Florida. She had gained weight and developed drooping of the breasts over the years and did not want her implants. She didn't want replacement- but acknowledged that a lift would be necessary to improve appearance. She did not know her implant type ( other than saline) and was not having any concerns about breast implant illness. She was found to have capsular contracture on exam of her subglandular implants. At explantation- done with en bloc technique, she was found to have heavily encapsulated McGhan (same company that is now Allergan) implants . These are the same textured implants which have been recalled. There was calcifications around the right implant and the left side had an unsuspected old hematoma within the capsule. Capsule and fluid were submitted for pathology and no ALCL or other evidence of infection or cancer were found. She had a breast lift done simultaneously. She was very happy with her smaller perkier breasts and glad to be rid of her encapsulated implants. Textured implants have been associated with a form of lymphoma called ALCL. Although uncommon- it was an unexpected finding. The Allergan company recently recalled their textured devices since their brand had a higher proportion of reported cases. Removal is not recommended for all patients- in the absence of signs such as fluid collection or mass ;but many woman choose explantation because of fears of developing this disease