Capsular contracture

August 4, 2014

Ask Dr. Elliott: How to Prevent Capsular Contracture

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Over decades of practice, I have performed over 2,000 breast augmentation procedures and developed my skills through continuous research and implementation of the latest plastic surgery technologies. However, with any surgery, regardless of whether or not you visit a board-certified plastic and reconstructive surgeon, there are inherent risks when introducing foreign objects into the body.

When you undergo breast augmentation, FDA-approved saline implants or silicone implants are positioned to enhance the appearance of the breasts. In rare cases, scar tissue can become tough and form tightly around saline or silicone breast implants over time in a condition known as capsular contracture. It’s important to note that breast implants themselves do not become hard, rather the scar tissue is what composes the hardness. There are various ways to avoid capsular contracture, one of the most important being to choose an experienced surgeon who provides you with the proper post procedure care guidelines. Learn more in the following video.

We will continue to post new videos discussing various aspects of plastic and reconstructive surgery in the coming months. If you would like to schedule a consultation in order to have your questions answered personally for your needs, please contact us today. For more on breast reconstruction and other procedures, please visit my website and follow me, Dr. Franklyn Elliott, on Facebook, Twitter, and Google +.

March 24, 2014

Breast Cancer Care: Radiation after Reconstruction with Breast Implants

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According to the American Cancer Society, as of 2012, over 2.9 million women in the United States with a history of breast cancer were living cancer-free or undergoing treatment. There are various methods of breast cancer treatment, including surgery, radiation, and systemic therapy. Many women with breast implants who undergo radiation treatment, such as chemotherapy, are concerned as to whether implants should be placed before or after radiation. Below, board-certified plastic and reconstructive surgeon Dr. Franklyn Elliott explains the answer to this breast cancer care question.

breast reconstruction atlanta georgia Radiation therapy often follows breast-conserving surgery and uses high-energy beams and particles to kill cancer cells in the body in order to prevent the recurrence of breast cancer. While it can destroy cancer cells remaining in the breast, chest wall, and underarm area after surgery, radiation affects blood supply to skin and deep tissues which can cause the occurrence of scar tissue.

However, this does not mean that women who have saline or silicone breast implants cannot have radiation therapy. Rather, the presence of implants just makes radiation therapy planning more multifaceted. Radiation can cause scarring and hardening of the implant, leading to a less natural look. With breast implants being in the area of treatment, they would be subject to the changes in blood supply caused by radiation.

As the skin and muscle scars after radiation therapy, so does the scar capsule surrounding the implant. This increases the threat of capsular contracture, which occurs when a patient’s body reacts to a foreign object and forms a “capsule” around the implant. The additional scarring causes the capsule to tighten around the implant, creating a condition in which the breast appears hardened and uncharacteristic of a healthy breast. While the implant itself remains unaffected, the tissue around it can be modified greatly. This condition can generally be treated with success though with capsular surgery and implant exchange.

Typically without extensive complication, breast cancer patients can have radiation therapy after TRAM flap reconstruction procedures with tissue expanders. However, it is essential to remember that the tissue will still be affected (i.e., scarring, changes in blood flow). This means the skin and fat used in reconstruction may not be as soft and natural-feeling as it would be if it were not part of radiation therapy. On the other hand depending in the radiation therapy technique the TRAM flap may be – in up to 60% of cases- be essentially unaffected by the radiation. Dr. Elliott can delay breast reconstruction if his patients need radiation so that they may use healthy tissue that has not been affected by the treatment. Although each patient’s situation is unique, Dr. Elliott generally prefers the TRAM flap procedure in situations where radiation therapy is involved.

Ultimately, the decision to undergo radiation with the presence of breast implants is the patient’s choice. If you are interested in breast revision for implant removal or want to learn more, please contact our office today to schedule a consultation. Stay up to date on the latest breast cancer and breast reconstruction news by following Dr. Elliott on Facebook, Twitter, and Google+.

June 29, 2012

Reasons for Breast Revision Surgery

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Reasons for Breast Revision Surgery There are many reasons why women may consider breast revision. Plastic and reconstructive surgeons are frequently asked what makes a woman a candidate for breast revision surgery (also known as secondary breast surgery) after a previously performed breast augmentation? Dr. Franklyn Elliott has been performing cosmetic and reconstructive breast surgery for over 25 years and regularly teaches other surgeons new and effective breast surgery techniques including those for secondary breast surgery. Below are some of the most frequent breast revision surgery motives he encounters along with what he frequently suggests to mitigate the issues.

Patients who wish to exchange their breast implants for a different size or type, are not satisfied with their results, or those who develop complications may wish to correct their prior procedure. Breast revision surgery may be crucial if implant rupture, capsular contracture, or infection occurs. Rupturing or leaking is rare, but if this does happen the implants will need to be removed. Many patients choose to have their breast implants replaced upon removal, but for others, a plastic and reconstructive surgeon can utilize breast reduction and lifting techniques during breast revision to create optimal results without needing an implant. Contrary to many beliefs, breast implants themselves do not get hard, but scar tissue around implants can become this way, creating capsular contracture. The best way to avoid capsular contracture is to follow breast augmentation aftercare instructions by limiting physical activity and wearing any prescribed post-surgery supportive garments. If the complication does occur, a capsulectomy can be performed during breast revision to remove excess scar tissue and soften the breasts. Infection and allergy are very rare but there is still a chance that a woman’s body could reject the breast implant, ultimately causing an infection.

Although there are medical conditions that may make breast revision surgery necessary, other aesthetic changes may warrant revision. Even with proper planning and execution of breast augmentation surgery, changes such as weight loss or gain can occur later leading many women to consider and undergo breast revision surgery.

Weight fluctuation throughout your lifetime is very common, and breast augmentation patients are likely to experience weight gain or loss at some point after their surgery, especially if they plan on having children. Breast revision surgery can help maintain overall body proportion. Sometimes women struggle to choose an implant that satisfies their needs and may desire smaller or larger implants or to switch their salineimplants to silicone or vice versa, in either case implants can be replaced. No matter the reason for breast revision surgery, it’s important to discuss your concerns with a plastic surgeon you trust and feel comfortable talking with. Additionally, selecting a surgeon who is active within professional plastic surgery associations and breast surgery symposia is another to ensure your provider has the latest education in surgical techniques and plastic surgery technology.

Every patient is an individual and should be evaluated and treated based on their unique case. It’s imperative to do your research and make sure your plastic surgeon is experienced in performing this surgery and is board certified in plastic and reconstructive surgery. To stay up to date on the latest breast news, make sure to follow Dr. Elliott on Facebook, Twitter, and Google+. You can also sign up for his newsletter.

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