Implant Exchange with Capsulectomy in Raleigh, North Carolina*

This 60-year-old woman had breast implants placed 35 years ago and over the years had developed hardening and distortion of her breast implants. She had no information about the implant type. She went to see Dr.Lyle who noted heavily thickened capsules with firmer breast implants sitting quite far apart on the chest. They looked quite unnatural and were uncomfortable. This is called Baker IV encapsulation. The patient desired to be about the same size if possible and also did not want a breast lift ( although Dr. Lyle recommended one) but did agree to a periareolar mastopexy to reduce the size of the areola. At surgery Dr. Lyle found calcified capsules and removed the capsules in their entirety. Inside were discovered ruptured silicone gel dual chambered breast implants that were about 250 cc and had heavy calcification within the capsule. Because of the severity of the encapsulation, a site change was done placing the implants under the pectoral muscle and using xenograft--called Strattice–that has been shown to reduce recurrent capsular contracture. This product is derived from pigskin but all of the cells and antigens have been removed and this is used in cosmetic and reconstructive procedures. She had 330 cc moderate plus Sientra silicone gel breast implants placed. She did require drain tubes which were removed in 1 week. She did quite well with the surgery and was pleased with the more natural and softer breasts