What is a Capsulectomy?

The capsule can be of variable thickness and have different properties from patient to patient and even right breast vs. left breast. Thicker capsules or those that contain muscle cells can cause mishaping of the breast and in some cases also cause pain - capsule contracture. It is not known exactly why some capsules become more problematic cosmetically speaking than others. It is thought that blood around the implant at the time of surgery or low grade infection early or late after surgery in is the culprit. Some capsules cause problems early after surgery and some take years to transform into a problematic capsule. In all cases of problematic capsules the naturally round contour of the breast is flattened in one or more areas including the upper portions of the breast. This can also occur if a breast implant breaks or ruptures.

Prior to the 1990s this was treated by squeezing the breasts hard enough to break the capsule - closed capsulotomy. This resulted in high recurrence rates because the capsule was not removed and high implant rupture rates. Currently the standard of care is surgical removal of all or most of the capsule - total or subtotal capsulectomy.  There are no external balms, medications etc. that effectively treat capsular problems. In some cases capsule contracture especially if mild and shortly after surgery may be amenable to endermology.