Capsular Contracture Surgery By Dr. Jaibaji

In virtually every woman who has breast augmentation, the body responds to the presence of the implants by forming a capsule of scar tissue around the implant. Like scars on the skin surface, the development of scar tissue is a process that starts within days of surgery and continues for a year or more. Most often, the presence of this scar capsule is not detectable, and the breasts look and feel very natural. Sometimes, however, the capsule contracts around the implant. The breast will then feel firm to hard, and in some cases, the shape of the breast will be distorted.

What are Capsular contracture symptoms?

Capsular contracture is thickening or hardening of the scar tissue that forms around the breast implant. It can make the implant feel firmer. In more advanced cases the shape of the breast will change. The patient may also experience pain, The pain can occur when the breast is touched and it can be constant.

What causes Capsular Contracture?

No one knows exactly why the capsules surrounding the breast implants contract, nor can they predict who will develop this problem.

One hypothesis is that they occur because of an infectious stimulus. In spite of sterile techniques, bacteria are still present on the skin surface, in the air and within the ducts of the breast tissue. Every plastic surgeon has their own personal surgical ritual they believe lowers the chances of capsular contractures. Some are quite elaborate, and others very simple.

Most surgeons believe that adhering to these common-sense procedures will reduce the incidence of capsular contracture:

  • Avoiding incisions that go through the breast tissue (as they do in the peri-areolar incision technique)
  • Irrigating the implant and the pocket created to hold it with antibacterial agents
  • Giving the patient oral antibiotics around the time of surgery
  • Touching the implant as minimally as possible
  • Using talc-free gloves during surgery

Although some studies indicate that the rate of early capsular contractures is less when these techniques are used, there are to date no long-term studies to show they actually result in fewer capsular contractures overall. Other factors—such as implant placement above or below the pectoralis muscle, saline or silicone filler, surface texture of the implant, and post-operative massage—seem to affect the rate of capsular contracture. Capsular contractures are not life threatening, but they certainly don’t look or feel “natural.” They can also be painful and distorting.

What are the grade of capsular contracture?

Grade 1 : usually the patient is symptomatic

Grade 2: the breast is firmer and can be uncomfortable.

Grade 3: the breast shape changes. Usually the implant will move up causing noticeable difference. The breast will also feel firm.

Grade 4: The breast is not only misshaped but now it is painful to touch.


How to Avoid capsular contracture?

There are several techniques that help prevent capsular contracture. Non of them is an absolute guarantee that it will not happen, Good surgical technique, washing the implant and the pocket with antibiotic solution, breast messing and wearing a band after surgery can help reduce contracture.


Is there a medical treatment for capsular contracture?

There is but may not be successful and medical treatment can have side effects. Dr. Jaibaji will discuss the medical treatment option.


Capsular contracture surgery

In general, surgery is the most effective way to treat capsular contracture. The procedure is performed under anesthesia. The implant is removed and the capsule is removed. The same or a new implant can be used once the capsule is remove. You may require a drain placed.

Can I get a bigger implant after capsular contracture removal?

Yes you can. In general you can have the same size implant or go bigger. Dr. Jaibaji will discuss with you the type and size of implant that you can get. If you decide to go with a smaller implant then you may require some type of a lift to remove the excess skin.


Will capsular contracture happen again after the correction surgery?

Yes it can happen again. Although with good surgery and good after surgery care the ribs is lower.


Recurrent Capsular Contracture San Diego

Recurrent capsular contracture is a challenging problem. Recurrence of the capsular contracture can happen months after surgery. It can affect one or both breast.
The treatment of Recurrent Capsular Contracture needs to addressed in detail with the patients. The treatment options include;
1- Redo capsulectomy with or with out neopocket formation.
2- The use of Acellular Dermal Matrix (ADM) in the implant pocket. Strattice dermal matrix.
3- Several medication can be used to prevent or treat capsular contracture that are described in the literature. The use of these medication has to be discusses with your plastic surgery prior to using them.


If you are having problems with your breast implants and want to to get a consultation with with Dr. jaibaji please contact out office at 619 522 0821. Our staff would love to answer your questions and schedule a consultation.

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Patient Case Study

Gender: Female
Breast Surgery San Diego
Procedure Type: Capsular Contracture, Implant Placement: Sub muscular, Incision Site: Periareolar
Pre-Op Cup Size: DD, Post-Op Cup Size: DD
Implant Type: Allergen Natrelle Saline Implant, Implant Profile: High Profile
Implant Shape: Rounded, Implant Surface: Smooth

This patient from Orange County had breast augmentation. She developed capsular contracture of the left breast. Examination of the breast showed a  high riding left breast implant. She underwent capsulectomy of the left breast.

Patient Case Study

Gender: Female
Months Post-Op: 2
Breast Surgery San Diego
Procedure Type: Capsular Contracture
Implant Placement: Sub muscular, Incision Site: Periareolar
Pre-Op Cup Size: D, Post-Op Cup Size: D
Implant Type: Allergan Natrelle Saline Implant
Implant Profile: High Profile, Implant Shape: Rounded, Implant Surface: Smooth

This patient had breast augmentation with saline implants. She developed capsular contracture of the right breast. She underwent capsulectomy and placement of an implant. Capsular contracture, removal of breast implant, under the muscle.