Capsular Contracture Recalled implants with En Bloc Capsulectomy, Raleigh,NC*

What is a capsular contracture? . Capsular contracture around breast implants is the development of excessive scar surrounding the implant. It is The human body's way of walling off a foreign body. Capsules occur around any implanted device. When capsules become pathologic they can cause pain, distortion and hardness of the breast. The Baker grading system is used to describe the severity. Baker III describes firm breasts that appear distorted but don't cause much pain. Baker IV capsules are firm, distorted and painful. This 48-year-old woman had breast implants placed 24 years ago. They were saline devices but she did not know the manufacturer. She had Baker IV encapsulation and very firm breasts. She wished to have them removed and lifted with fat transfer. At surgery she was found to have heavily calcified encapsulated saline implants. They were textured and were on the recall list. Fortunately she did not have signs of ALCL-a rare form of lymphoma that can develop around textured devices. She underwent en bloc capsulectomy with breast lifting and a small amount of fat transfer. Fat transfer effectiveness is limited in these cases because the entire capsule was removed and very minimal breast tissue remained to allow any significant transfer but she did have about 90 cc placed in each side which did help improve the volume of the final result. She was very happy to have the implants removed and pleased with her smaller, lifted breasts