Alexandrina Saulis, MD, FACS
Board Certified Plastic Surgeon, Hinsdale, IL 120 E. Ogden Avenue Suite #204
Hinsdale, IL 60521

Capsulectomy, Capsulotomy, Capsulorrhaphy


When a foreign object gets inside your body, it forms a protective capsule of scar tissue around it. This scar tissue can get thick over time. This thickened scar tissue capsule can hold the implants in place for breast implants. However, this can cause a problem wherein the capsules tighten around the implants. This condition is called capsular contracture and affects up to 10% of people who have breast implants.

What is Capsulectomy?

Capsular contracture can bring chronic pain and breast distortion. A Capsulectomy is usually performed to treat this specific condition. This type of procedure removes the tough scar tissue around the breast implants.

Capsular contracture can have four different grades depending on the severity. Grades 1 and 2 are not considered significant, with the breasts feeling firmer. On the other hand, Grades 3 and 4 are more serious cases where the breasts look abnormal, hard, and painful. For people who are suffering between grades 3 and 4, a Capsulectomy or Capsulotomy will be recommended as a treatment plan. These two procedures can improve the look of the breasts and eliminate the pain.

There are two different types of Capsulectomy: Total Capsulectomy and En Bloc Capsulectomy.

Total Capsulectomy happens when the surgeon removes the breast implant and the entire capsule of scar tissue around it. The implant will be replaced eventually once the capsule is removed.

On the other hand, an En Bloc Capsulectomy happens when the surgeon removes the implant and capsule at the same time. This is often recommended for women with a damaged or ruptured breast implant.

What is Capsulotomy?

If the Capsular Contracture is not severe, a surgeon might elect to perform capsulotomy. Compared to the Capsulectomy, this is a less invasive procedure that involves removing the breast implant and a part or all of the capsule. The implant will be replaced afterward.

The type of surgery can either be open or closed. During open surgery, the surgeon will make an incision needed to remove the capsule and implant. On the other hand, closed surgery entails using an external compression that is used to break up the capsule. This type of surgery is rarely performed.

What is Capsulorrhaphy?

Another type of procedure that can be performed to eliminate the condition of capsular contracture is Capsulorrhaphy. This medical procedure reshapes and recontours the capsule to better fit the breast implants. It is minimally invasive because it avoids surgery to remove all or part of the capsules. It tightens the capsule pocket instead and repositions it to hold the breast implants correctly in place.

If you are suffering from capsular contracture, different treatments can be recommended to you, depending on your medical history and the severity of the condition. Reaching an informed decision with the help of a plastic surgeon is important so that you can be on the road to recovery before it is too late and your condition worsens. A board-certified plastic surgeon will assess your situation, deliver recommendations and guide you to the right path to start feeling better in no time.