Capsular Contracture: All You Need to Know

Capsular contracture is a complication that can affect women after breast augmentation or reconstruction surgery. Numbers will vary from study to study but overall may be as high as one in 10. So, what is capsular contracture? 

Human bodies are smart. When a breast implant is put inside the body it is recognized as a foreign object. The body creates a layer of scar tissue around it. We call this the capsule. It is the location where the implant will live. Massage routines are used to help ensure that the implants find their final position evenly, but also to ensure that the implant capsule stays soft and malleable. Ultimately we want the breast to have a soft and natural feeling.

In some patients the scar tissue around the implant can begin to contract or tighten.This “capsular contracture” can be mild but in some cases it can cause the patient to experience distortion, pain, or hardening of the breast. In some it can occur shortly after surgery in others it may not show up for years.

This article will delve further into capsular contracture to offer an in-depth description and outline the treatment options for it.

What Causes Capsular Contracture?

Capsular Contracture can occur due to a variety of reasons, including infection during a breast implant surgery, the formation of a hematoma, where blood pools around the implant or the development of a seroma, where fluid accumulates around the surgical area. That’s why most experienced plastic surgeons advise their patients to avoid taking any supplements and medications for at least two weeks before a procedure that might increase the risk of bleeding, such as Ibuprofen, Aspirin, vitamin E, and fish oil. 

Some recent studies have suggested that “Biofilm” could be the leading cause of capsular contracture. The theory is that bacteria trapped in this film may live around the implant leading to contracture. Tartar is an excellent example of Biofilm that forms on your teeth. 

What Are the Treatments?

Unfortunately non-surgical treatments such as drugs and even ultrasound regimens have not had uniform success.

Surgical treatment is the mainstay and can involve:

Capsulotomy, which means releasing the scar tissue around the implant to expand the capsule or in some cases:

• Capsulectomy is the complete removal of all the scar tissue.
• With either treatment contracture can recur, frustrating both surgeon and patient.
• There is evidence that laying of a specially prepared tissue around the implant may diminish the recurrence of contracture but these materials are still investigational and not yet approved by the Food & Drug Administration (FDA) for routine treatment.

However, you should also note that not all cases of capsular contracture need surgical treatment. Mild cases may not progress or even be visible.

Work With a Board Certified Plastic Surgeon.

In my own practice every effort is made to minimize this risk. Patients are asked to stop any medications that could increase the risk of bleeding. We ask them to limit activities post-operatively that could lead to bleeding as well. Massage is begun to help soften the capsule and position the implants as the patient heals. In surgery, all patients receive antibiotics and the implants and pockets are irrigated with antibiotic solutions.

We avoid touching the implants unless necessary and for gel implants I use an implant funnel that minimizes touching.

I prefer implants placed below the pectoral muscle where it is clear that the risk of contracture is lower.

While contractures can occur when everything is done right the key to me is to do the best we can to prevent them in the first place.

Choose Dr. Adam Tattelbaum for Your Breast Implant Procedures

If you have any questions or would like to schedule an appointment, please call my office at 301-656-6398 or 703-442-4919 or contact us online. 

May 22, 2020 1:33 am
Categories: Blog