En Bloc Capsulectomy /Implant Exchange Photos, Raleigh,, NC*

This 62-year-old woman had breast implants placed in the 1980s. They became firm soon after placement and her original physician performed a closed capsulotomy with no improvement in the firmness. She went many years without treatment and noted that the breasts started to become painful. She sought Dr. Lyle's help in removal of her implants. She did not really have health concerns about the implants and did not have any complaints or signs of breast implant illness. She wished to maintain the same volume but realized her breasts needed some degree of lifting. She underwent en bloc capsulectomy with removal of the implants within the capsules. These were subglandular implants. The implants were McGhann ( now Allergan) 220 cc gel implants with the right side being totally disrupted but within the capsule and the left side disrupted and leaking and also enclosed within the capsule. To avoid potential recurrent capsular contracture, she had site change to the subpectoral position and simultaneous mastopexy. The new implants were Sientra 305 cc gel implants. Her capsules were so thickened that larger implants were necessary to achieve a similar size breast. Replacing implants that are heavily encapsulated usually requires placement in a new location such as sub muscular position or in some instances, use of allograft or xenograft mesh material which has been shown to reduce chance of future capsular contracture She was very happy with the outcome