CAPSULAR CONTRACTURE LEADING TO INEVITABLE EXTRUSION OF IMPLANT
The patient below presents status post delivery and breastfeeding for six months. The patient presents with severe Baker IV capsular contracture on the left with a Baker III on the right. The red 2 x 3 cm area above the 12 o’clock position of the left nipple is associated with severe tissue damage atrophy and irritation which if left untreated with a decompression open capsulotomy, would certainly lead to full thickness skin loss with extrusion and exposure of the left implant.
The patient presents with severe pain. There is no evidence of lymphadenopathy, cellulitis or mastitis to the breast; however, the encapsulation is so severe circumferentially around the implant on the left side that it is leading to the edge folding outward, causing severe constant irritation of the subdermis which will lead to full thickness tissue loss and exposure.
The next photograph shows decompression six weeks postoperative with relaxing open capsulotomies and anterior capsulectomy. The implants have been replaced with 500 to 550 cc high profile saline implants. She now presents with soft breasts bilaterally, no further incidents or evidence of irritation to this area with no visible distortion. Decompression is extremely important as soon as the patient starts to develop skin irritation and dermal atrophic changes, as seen on her preoperative photo, to prevent an inevitable exposure of the implant which may lead to an infection and/or loss of the implant.