The main problem in breast augmentation. You can see a few photographs of serious capsular fibrosis here
When old blood remains sitting around the implant, it wil be broken down in the course of the following weeks. With larger amounts of blood, this leads to “in-capsulation” of the implant. There is a mantle of scar tissue building up around the implant. Muscle-like cells also appear in this scar tissue and literally strangle the implant. The implant adopts the form by which it defends itself best : a sfere.
Depending on the grade of capsular fibrosis, it will be felt by the patient, it will be painful and it will be visible as an unnatural rounded implant, sitting tight under the skin.
Prevention is the best solution : the amount of old blood needs to be removed as much as possible.
I rinse the area with saline and putt drains if necessary so that all blood comes out before it gets the opportunity to clot.
An established capsular fibrosis needs to be adressed surgically by:
This is a film about capsulectomy.The problem with capsulectomy is that one creates a new raw surface that needs to heal , with subsequent scarring and contraction. The fact that the breast looks good after the operation, does not guarantee it will be o.k. a few weeks later.
There is always a small chance for bleeding after the operation. It needs to be adressed immediately if significant. The risks are that the suture will not hold, that it will eventually lead to capsular fibrosis or a loss of implant.
In order to prevent this :
In case of loss of the implant, time is given to heal and a new implant can be inserted in 6 months time.
It happens when there is profuse bleeding ( see above)
It also happens in case a patient smokes a lot before and after the operation. The quality of the healing can be impaired and the suture will open within 10 days.
The treatment consists of removing the implant-which probably is infected - in order to replace it after 6 months.
The infection of implants is very rare, but possible. The implant need to be removed and the infection then subsides spontaneously. Nevertheless antibiotics are given for about 10 days.
The most frequent occurrences are linked to smoking and hematoma's (collection of blood)
The nipple and the areola are innervated by a single nerve. If it is severed, numbness of the nipple-areola area ensues. The sensitivity can partially return because of the network of skin nerves.
I prevent the tearing of this nerve by injecting lots of fluids under the breast before surgery. In this way I can feel this small but though nerve and preserve it.
innervation to the nipple