Also called capsule release surgery, it cuts the original tightened capsules in circles or crisscrosses with electrosurgical units (ESUs) to expand the contracted implant space. A transaxillary, periareolar, or inframammary incision is created with the aid of an endoscope. Pocket size depends on the severity of contracture, and total or partial capsulotomy can be performed. Implants may not need to be changed but can be upgraded if one desires. Despite having advantages such as less pain, shorter surgical duration, and quicker recovery, capsulotomy does not completely remove the capsules, and some capsular tissue still remains in the body. Therefore, it is ineffective against constitutional, refractory, or potential infectious capsular contracture and may result in recurrence. Thus, patients should pay extra attention to postoperative massage. At present, this surgery is mostly performed on patients with mild to moderate (grade 2-3) capsular contracture or is unilaterally used to adjust uneven implant heights or texture. It is not recommended for grade 4 severe capsular contracture.

Surgical conditions

Duration

0.5hr(for one side)

Type of anesthesia: IV sedation or general anesthesia
Type of incision: Previous incision or transaxillary, periareolar, or inframammary incision
Recovery: Within 5–7 days
Removal of stitches: 7–10 days

General instructions

No food and water on the day of surgery

0hr

Tasks and exercises that require excessive arm strength should be avoided for 1 month postoperatively.
Smoking and consumption of collagen or vitamin C should be avoided for 3 months postoperatively to prevent the formation of capsules.
Underwired or push-up bras should not be worn for 3 months postoperatively.
Breast massage should be performed for at least 6 months postoperatively.

Ideal candidates

Those with mild to moderate capsular contracture
Those with unilateral implant displacement (uneven height) or difference in breast texture
Those with partially contracted implant or asymmetric breasts
Those who would like to increase implant size but do not have enough pocket space
Those who feel that implants are not soft enough

Possible complications

Hematoma
Infection
Seroma
Scar adhesion
Capsular contracture recurrence
Implant leakage or rupture

Surgical advantages

Less invasive and quicker recovery.
Less postoperative swelling, pain, or bleeding.
Surgery with minimal pain.
Effective expansion of contracted space; fast realization of surgical results
Implants can be replaced for upgraded cup size.

Surgical drawbacks

Capsules are only cut but not eliminated; thus, there is a possibility of recurrence.
Not effective against constitutional, refractory, or infectious capsular contracture
The results may not be satisfactory for grade 3 or 4 capsular contracture.
Longer postoperative care or massage is required to prevent recurrence.