What are Breast Capsulotomy and Capsulectomy?

Breast capsulotomy and capsulectomy are surgical procedures done to treat hardened and painful breast implants. This is a condition known as capsular contracture. Capsular contracture is a complication of breast augmentation that may occur within weeks or even several years after your procedure. It is caused by scar tissue that thickens and forms a hardened capsule around your breast implant. These capsules can cause your breasts to not only feel painful, but also look distorted, and your implants may move out of place. Surgery releases your implants from the scar tissue (capsulotomy) or removes it (capsulectomy), relieving your symptoms.

Breast capsulotomy begins with an incision in your breast to reach the implant. Your surgeon then makes cuts in the capsule to release it from scar tissue. Breast capsulotomy is most often performed surgically, although closed capsulotomies are possible. In a closed capsulotomy, your breasts are manually manipulated through the skin to break up scar tissue, so no incision is required. However, closed procedures are not recommended as they not only lead to complications such as ruptured implants and hematomas, but they also void your implants' warranty.

Breast capsulectomy is performed similarly to open breast capsulotomy. Instead of cutting the hardened capsule, your surgeon partially or totally removes it. Typically, your old implants are replaced with new ones to reduce the risk of recurrence of contracture. Capsulectomy is generally performed when the capsules are too thick to be treated by capsulotomy. Capsulotomy may be done for small-breasted women because capsulectomy reduces the thickness of breast tissue and can cause implants to look unnatural.

Either surgery will require around 2-3 hours, and you should be able to return home the day of your operation. Your breasts may be sensitive for up to two weeks, and you may need to wear a special bra or take pain relief medication. Exercise and other strenuous activities should be restricted following your procedure, but normal activities can generally be resumed within 2-3 weeks.

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