Management of Double Capsule

Capsular contracture and implant displacement are the leading causes for reoperations in breast implant surgery. Texturing of the implant surface was initially developed to stabilize the implant in the breast pocket and demonstrated lower capsular contracture rates and implant malposition rates compared to smooth implants. With the increased use of macrotextured implants, the double capsule phenomenon had emerged, which raised questions regarding the clinical significance, complications, and management of this phenomenon. Furthermore, concerns were raised on a possible linkage to late seroma and BIA-ALCL. The exact pathophysiology of double capsule formation is still undetermined but is likely to be multifactorial. Most cases of double capsule are asymptomatic and do not require any surgical or nonsurgical intervention. In cases of capsular contracture, late seroma, and implant malposition, the management is according to the relevant treatment protocol, with treatment adjustments to reduce the chance of recurrent double capsule.