A. I had a mastectomy of my right breast with reconstruction. The implant has encapsulated three times. Is there another way to replace the implant to avoid another encapsulation?
Both doctors weighed in on this question:
A. Hi, I’m sorry you are having so much trouble with your reconstruction. Of course, at this point, I don’t know much about the specifics of your reconstruction, but I can offer some general comments.
For many years, implant reconstruction was done with the implant under the pectoralis muscle. More recently, acellular dermal matrix (ADM, or processed cadaver skin) has been used as a “muscle extender”, to varying extents. More recently, yet, there has been a huge increase in placing implants in front of the muscle, often with a full ADM wrap.
In our experience, this has resulted in a very significant decrease in contracture rates, while also resulting in more natural-looking and feeling breasts in many cases. We have developed significant experience converting patients with previous submuscular implants to the new “pre-pectoral” (in front of the muscle) method, with (thus far) uniformly positive patient impressions.
Of course, most patients also have the option of removing the implant altogether and being reconstructed only with their own natural tissue. This is more involved, but makes the most natural breast possible. If you would like to discuss your situation in more detail, I would be happy to chat with you by phone, or see you in our office.
– Richard M. Kline, Jr., MD
A 2. Hi. Thank you for your question. I am sorry you have had problems with your implant breast reconstruction. Since you have had to repair it three times, I am wondering if you had radiation? Even if the answer is no, it is apparent that your body is reacting to the implant by forming capsular contracture.
It is likely to occur again, even if you have it repaired again as long as an implant remains. The good news is that there is likely a solution. In our practice, we have helped many women in your situation. The most likely option to solve your problem would be to replace the implant with your own fatty tissue without sacrificing any of your important muscles. The most common area to get the fat is the tummy tissue.
If you feel like you don’t have extra fatty tissue there, it is possible to use another area of your body. I would be glad to discuss your situation in detail. I could also see you in person for a consult. Let me know what works best for you, and I will have my office make arrangements.
– Thanks again, Dr. James Craigie