Encapsulation - How many attempts at correction are too many?

[vttgl101]

I'm 47 y/o and over the last three years, have had 5 breast surgeries to correct encapsulation (hardening, distortion of position and pain) of my left breast.  Previously experienced encapsulation in right breast (2006) that corrected after one procedure but left just continues to recur.  I know and understand that the chance of correction is small but my question is, how many times is just too many attempts to correct without doing permanent damage to my breast tissue?  What are the long term effects, if any?  I waited one full year this time (5th attempt now) to correct left side (right is soft and has NO capsule) and am considering what my next step will be if I don't get correction again this time.  Thanks for your reply.

[Howard Rosenberg, MD]

In addition to neo-pocket formation, some surgeons advocate use of a collagen matrix sheeting to correct this problem.  Your best alternative would be to consult with a local plastic surgeon about these alternatives since these are obviously surgical procedures that any surgeon performing them for you must be familiar with the techniques.

[vttgl101]

Implants are submuscular, 780cc's (saline).  Repeated encapsulation correction procedure has been described by surgeon as a complete removal of capsule, disinfecting of pocket and implant replacement.  Surgeon is a breast reconstruction specialist and has performed all 5 procedures however I agree with you that a new approach (and possibly surgeon) must be considered moving forward.  Could you please provide additional information/resources regarding alternative surgical approaches such as the 'neo-pocket' procedure you mention?  Are there any other alternatives?  Your follow-up reply is greatly appreciated.  Thank you.

[Howard Rosenberg, MD]

With repeated formation of capsule contracture after multiple procedures, the question of a new approach to correct the problem should be considered.  Assuming your implants are submusclular, one approach might be the creation of a neo-pocket between the existing capsule and the muscle.  Since I do not have information or details about what previous procedures where performed, I cannot comment about what new approach should be attempted.