Open Capsulotomy

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An open capsulotomy works in a similar way to a closed capsulotomy but through a surgical procedure.  Your surgeon will cut the capsule wall surrounding your implant in order to release the pressure placed on your breast.  This is one of the preferred ways to treat capsular contraction, and is the most likely to be offered to you. 


Only a qualified cosmetic surgeon can perform an open capsulotomy, and preferably an experienced surgeon with many past cases of breast augmentation and capsulotomy.  It is best that you go to your initial cosmetic surgeon for your capsulotomy, as they will have notes about your augmentation, and are best placed to perform the procedure.  Your surgeon ought to be willing to show you photographs of previous capsulotomies, and will be able to talk you through the procedure and put your mind at ease.  If you are at all concerned about the experience of your surgeon then you ought to find another to perform your open capsulotomy. 

The Procedure

An open capsulotomy will take around two or three hours to complete, depending on the severity of your capsular contraction.  You will need to be placed under a general anaesthetic, and it is also likely that you will need to stay overnight within the hospital.  The surgeon will make incisions into the hardened capsule surrounding your implant, often these will occur in the breast crease, the areola, where your previous incisions were made for your breast augmentation or the armpit to minimise the scarring left visible by the procedure. 

After the operation your surgeon is likely to use drains in order to prevent excessive swelling of the area.  These, along with your stitches, will need to be removed about a week or two after surgery.

Open Capsulotomy Risks

Due to the surgical nature of an open capsulotomy, there are several risks associated with the procedure:

  • Allergies to the anaesthetic used
  • Infection occurring due to the invasive nature of the procedure
  • Swelling of the breast area
  • Additional scarring on top of that produced by your initial augmentation
  • The capsular contraction can reappear, this might not cure the problem and then further surgery will need to take place
  • Formation of haematoma
  • A loss or change of sensation around the breast area or nipples following surgery
  • Excessive bleeding
  • Not being able to breastfeed in the future
  • A difference in the two breasts’ appearance

Although the Open Capsulotomy procedure does contain some risks, they are small in comparison to a closed capsulotomy.  Your surgeon will be able to talk you through all of the risks associated with an open capsulotomy procedure if you have any worries.

The Results

An open capsulotomy has a good chance of being successful, and the cuts made to the capsule of hardened tissue will generally allow the pressure to be taken off and your breast to return to its previous form.  The implant is given more room, and will sit in the area without being squeezed any further.

The real concern that some people have is that in some instances the capsule can mend the sutures made during the surgery, and then continue to shrink.  This would mean that even more surgery is necessary in the future, the results not being permanent in all cases. 

Everyone is different and will react to the surgery in different ways.  If you have any allergies to medicines then you ought to tell your surgeon straight away, as well as if you are taking any medications or herbal supplements on a regular basis.  This will allow them to take any extra precautions that they might feel necessary.  It is believed that massaging your breast following an open capsulotomy can help to prevent the capsule from hardening again, and many surgeons recommend that you continue with this regularly for a year after the surgery.  It cannot be predicted whether you will experience re-hardening of the shell or not. 

Recovering from a Capsulotomy

If you undergo an open capsulotomy it is likely that you will be asked to stay in hospital overnight following your general anaesthetic.  The following day you will be able to walk around and undertake light activities and most people can start back at work after few days however this will depend on the nature of your employment.  You will need to take it easy for a month following your open capsulotomy, during this time you will have consultations with your surgeons to ensure that your treatment has worked.

Your surgeon will give you details on how best to aid your recovery following an open capsulotomy.  These are likely to include:

  • Massaging your breasts to prevent the capsule from hardening by moving the implant slightly on a regular basis
  • Taking vitamin E supplements to help prevent the hardening of the tissue surrounding your implant
  • Not smoking, as this can limit the amount of oxygen to reach your damaged tissue and skin, which could cause delayed healing or cause complications in the future

Although taking these measures will not guarantee that your capsulotomy procedure will be successful, they can help to prevent the severity of the tissue hardening.

The Costs

The cost of your open capsulotomy will depend on several factors.  These include:

  • The location of the procedure
  • Which surgeon performs your procedure
  • Whether treatment for capsulotomy is included in your aftercare plan or insurance for your breast augmentation. 

To find out how much your capsulotomy will cost it is best to get a quote following a consultation with your chosen surgeon.

It is very unlikely that you will get any NHS funding or help for a capsulotomy.  The NHS rarely funds any elective form of surgery, and this includes cosmetic breast augmentation.  If your capsular contraction is causing you a lot of pain, however, then it might be worth asking.  If you are struggling to find the money to fund your capsulotomy then there are cosmetic surgery finance companies that might be able to provide you with a loan to pay for your procedure.  If you take this option you must be prepared to pay high rates of interest. 

It is important to take into consideration the amount of money that you might lose from taking days off work, as this might be something that you overlook initially.  You must ensure that you are prepared to take at least a couple of days off work following your open capsulotomy.

The Advantages

An open capsulotomy provides many with a good method for relieving the symptoms of capsular contraction, and will normally result in a long-term solution to this problem.  An open capsular contraction will:

  • Allow your surgeon greater control over where the tear in the capsule is to be placed
  • Cause less pain than a closed capsulotomy
  • Allow your breast implants warranty to remain valid
  • Give you a high chance of success
  • Only result in minimal scarring

An open capsulotomy is much preferable to a closed one, and will generate better results without many of the risks.  Generally the procedure is cheaper than a capsulectomy, mainly because it isn’t so complicated but also due to the disadvantages that are also apparent.

The Disadvantages

The main disadvantage of an open capsulotomy is that sometimes the procedure doesn’t work permanently and the tissue surrounding the implant continues to harden once the new cuts have healed up.  This would mean that further surgery would be necessary, probably a capsulectomy, to prevent the situation from arising again. 

An open capsulotomy does contain the risks connected with any surgical procedures, including infection, excessive bleeding and haematoma.  Scars will always be a part of any surgical procedure, however these can be made as small and unnoticeable as is possible, by placing them under the armpit or around the areola.  There are disadvantages to an open capsulotomy, but it does offer you a way of relieving the distress of capsular contraction at an affordable rate, with a good chance of success.

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Guide to Capsular Contraction