Researching breast implant surgery abroad, you meet terms such as capsular contracture, silent rupture, BIA-ALCL and en bloc before you meet a surgeon. Below is what each term means, with the U&U guide that covers the topic in depth. Whether any of them applies to you is settled at U&U after an in-clinic breast ultrasound and a talk with your surgeon.
Medically reviewed byKikap Kim · Chief Director, Plastic Surgery
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After an implant is placed, the body forms a thin capsule around it. Capsular contracture is when that capsule thickens and tightens, so the breast feels firm and, in severe cases, the implant is squeezed. It can affect one or both sides and may be more common after infection, haematoma or seroma.
A capsulotomy cuts the capsule to release its tension. A partial or total capsulectomy removes part or all of it. En bloc removes the capsule and the implant together in one piece without opening it, and is considered when rupture is confirmed or leakage is suspected.
A rupture is a tear or hole in the implant shell. Most silicone implant ruptures cause no symptoms, so the breast looks and feels the same and a hand examination can miss it. That is why an ultrasound or MRI check is worth having even when nothing feels wrong.
BIA-ALCL is not breast cancer. It is a type of non-Hodgkin's lymphoma, a cancer of the immune system, usually found in the scar tissue and fluid next to the implant, and it is reported more often with textured implants. The FDA describes an individual's risk as low. Once it is confirmed, the usual treatment takes out the implant and the surrounding scar capsule together, a larger operation than removing the implant alone.
Implants divide by surface: the smooth family and the textured family, whose shell carries a fine relief. The surface changes how tissue responds to the implant and how it settles, and each manufacturer has its own surface technology.
These name the layer the implant goes into. Subfascial places it above the pectoralis major, under the fascia that covers the muscle. Dual plane places the upper part of the implant under the muscle and the lower part under the breast gland. The layer is chosen from tissue thickness and the shape you want, and it changes the difficulty and length of surgery.
Three routes are used to place an implant: the armpit, the inframammary fold under the breast, and the edge of the areola. The route decides where the scar sits and how the surgeon reaches the pocket.
A vacuum-assisted breast biopsy device. Guided by ultrasound, a needle goes in through one small incision and draws tissue out by suction, for a biopsy or to remove a small benign lump. At U&U the on-site breast surgery director performs it in the clinic.
The implant drops below the inframammary fold, so the lower breast lengthens and the nipple looks as if it points upward. It is corrected with revision surgery that rebuilds the implant pocket and secures the fold.
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