We were interested to read Pandya and Dickson's short report on a capsule within a capsule,
1.
as we have recently published an article ‘True double capsules in oil-based (Trilucent) breast implants’.2.
In both reports, cosmetic augmentation using textured implants was performed on young women with no immediate postoperative complications and, in each case, further surgery was performed within 2 years of the initial procedure. Pandya and Dickson suggest that the double capsules may be caused by the tightly adherent capsule-implant complex shearing from the breast tissue with vigorous movement, resulting in haematoma and subsequent organisation, and that ‘irritation’ causes seroma. We have suggested that implant bleed3.
(histology revealed that foreign material was present in both capsules) causes excessive irritation,4.
creating an inner capsule. Bleed through this capsule or irritation by the foreign material within it leads to the formation of an outer capsule adherent to the chest-wall cavity. There were only small amounts of seroma in both our cases and no organised haematoma. We do not think that the outer capsule splits from the inner one, and believe that the strands found connecting the capsules in one of our cases are adhesions rather than the vestiges of separation.References
- Capsule within a capsule: an unusual entity.Br J Plast Surg. 2002; 55: 455-456
- True double capsules in oil-based (Trilucent) breast implants.Br J Plast Surg. 2002; 55: 270-271
- Bleed of and biologic response to triglyceride filler used in radiolucent breast implants.Plast Reconstr Surg. 1996; 97: 1179-1195
- Local tissue reactions to oil-based breast implant bleed.Br J Plast Surg. 2000; 53: 317-318
Article info
Footnotes
☆The Publisher apologises for the omission of the first two author's names in the previously published version of this letter (British Journal of Plastic Surgery 2003; 56: 76).
Identification
Copyright
© 2003 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
