Capsular contracture release (eg, Sever type procedure)
CPT4 code
Name of the Procedure:
Capsular Contracture Release (e.g., Sever Type Procedure)
Summary
Capsular contracture release is a surgical procedure where the scar tissue capsule that has formed around a breast implant is removed or released to address the issue of capsular contracture. This condition occurs when the scar tissue around the implant tightens, causing pain, discomfort, and potential deformation of the breast.
Purpose
The procedure addresses capsular contracture, which is a common complication following breast augmentation or reconstruction. The primary goals are to relieve pain, restore the breast's natural appearance and softness, and improve the patient's overall quality of life.
Indications
- Persistent pain or discomfort in the breast area
- Noticeable hardening or tightness around the breast implant
- Distortion or misshaping of the breast
- Restricted range of motion in the chest area
- Diagnosis of capsular contracture through clinical evaluation
Preparation
- Fasting for at least 6-8 hours prior to surgery
- Discontinuing certain medications like blood thinners as advised by the surgeon
- Preoperative imaging studies (e.g., ultrasound or MRI) to assess the extent of the contracture
- Blood tests and other routine preoperative health assessments
Procedure Description
- The patient is administered general anesthesia for complete sedation.
- The surgeon makes an incision, typically following the previous surgical scars to minimize additional scarring.
- The scar tissue capsule around the implant is either partially or entirely removed (capsulectomy) or incised to release the tension (capsulotomy).
- The breast implant may be repositioned or replaced if necessary.
- The incision is closed with sutures, and a sterile dressing is applied.
Duration
The procedure typically takes 1-3 hours depending on the complexity and extent of the contracture.
Setting
The procedure is usually performed in a hospital or an accredited outpatient surgical center.
Personnel
- Plastic Surgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technicians
Risks and Complications
- Infection
- Bleeding or hematoma
- Anesthesia-related risks
- Implant rupture or damage
- Recurrence of capsular contracture
- Scarring or changes in breast sensation
Benefits
- Relief from pain and discomfort
- Improvement in breast aesthetics and symmetry
- Restoration of soft and natural-feeling breasts
- Enhanced quality of life and self-esteem
Recovery
- Postoperative care includes managing pain and swelling with prescribed medications.
- Wearing a surgical bra or compression garment as advised.
- Limited physical activity for several weeks.
- Follow-up appointments with the surgeon to monitor healing.
- Most patients can return to normal activities within 4-6 weeks.
Alternatives
- Non-surgical options like massage or medication, though typically less effective
- Expectant management (watchful waiting)
- Removal of the implants without replacement
Pros and Cons of Alternatives:
## Non-surgical Treatments
- Pros: Less invasive, no recovery time
- Cons: Often less effective, temporary relief
## Watchful Waiting
- Pros: No immediate intervention
- Cons: Risk of worsening symptoms
## Implant Removal
- Pros: Eliminates risk of future contracture
- Cons: Loss of breast volume, additional surgery needed for reconstruction
Patient Experience
During the procedure, the patient is under general anesthesia and will not feel anything. Postoperatively, there may be discomfort, swelling, and bruising, managed with prescribed pain medication. It is crucial for patients to follow postoperative care instructions to ensure proper healing and minimize complications. The improvement in symptoms and appearance can often be noticed within a few weeks.