Endoscopic capsulotomy offers an improved method for examining and treating firm breasts with capsular contracture following breast augmentation. With heightened concern over possible problems related to leakage of silicone gel from older implants, many techniques have been utilized to help patients determine if their implants are leaking. Unfortunately, most current diagnostic tests are apt to miss cases of leakage. Obviously the surest way is to look directly at the implant. A new technique of endoscopic examination developed at our Center allows direct examination of the implant through a tiny incision in the nipple. When there is leakage, the gel can be seen outside of the implant. If leakage is detected, subsequent treatment can be planned on an elective basis. Additionally, the technique has been further developed to allow endoscopic treatment of firm breasts following augmentation when patients have developed capsular contracture. Using an instrument of our design which combines and endoscope with a guided laser beam, the capsule can be cut to release the pressure on the implant. A series of incisions are made around the implant until the capsule is completely loosened. The use of the laser makes bleeding unlikely, and no dressings or special follow up care is required. In selected cases, we have been able to use this technique to reposition misplaced implants. Patients find the technique to be relatively painless and can generally return to normal activity the following day. The surgery is done on an outpatient basis under a light general anesthetic. While most patients find that there implants are softened to a natural state, there is the possibility of reocourrance of the condition. For that reason, patients are generally advised to begin stretching exercises to attempt to prevent further scar contracture. Related news article on endoscopic breast examination and surgery from Orange County Register refers to Dr. Tobin's technique. News Index

Sign up for our email newsletter