Capsular Contracture Treatment By Dr. Jaibaji
What is capsular contracture?
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. In addition, pain is a symptom of severe capsular contracture.
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. The implant usually moves up, therefore, the affected breast will look higher.
Capsular Contracture pain
When a patient with breast implant starts to get breast pain it usually mean they have grade 4 capsular contracture. The pain is usually constant. Moreover, the pain is worse when wearing a bra or any pressure on the breast.
How common is Capsular Contracture?
No one knows exactly why the capsules surrounding the breast implants contract, nor can they predict who will develop this problem. However, Capsular contracture statistics show that the incidence is about 8%- 12%.
In addition, many studied have shown that placing the implant under the pectorals muscle will reduce the incidence of capsular contracture.
Capsular Contracture causes
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.
capsular contracture grades:
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.
Capsular contracture prevention?
There are several techniques that help prevent capsular contracture. Non of them is an absolute guarantee that it will not happen. However, good surgical technique, washing the implant and the pocket with antibiotic solution, breast messing and wearing a band after surgery can help reduce contracture.
Medical treatment for capsular contracture?
There is, it but may not be successful and medical treatment can have side effects. Dr. Jaibaji will discuss the medical treatment option.
Capsular contracture massage
One way to prevent capsular contracture is to massage the breast after implant placement. Hence, at Jaibaji Plastic Surgery, we instruct the patient about massaging the breasts post breast augmentation.
However, once capsular contracture forms, massaging will have very limited if any effect in treating the contracture.
Capsular contracture surgery and removal
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. Moreover, the same or a new implant can be used once the capsule is remove. In addition, you may require a drain placed.
Can I get a bigger implant after capsular contracture removal?
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 and adjust the pocket.
Capsular contracture after radiation
For women who had breast cancer and radiation therapy, placing an implant or expander fro reconstruction will result in capsular contracture.
The effect of radiation on the implant can, however, be significantly reduced by placing a non irradiated tissue, such as a muscle flap over the implant. In some cases the use of fat graft or dermal matrix will help. Dr. Jaibaji will explain to you how to reduce the risk of capsular contracture after or before radiation therapy.
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.
Capsular Contracture images
Below are pictures of capsular contracture before and after treatment. Surgery remains the main stay treatment of capsular contracture.
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.
Patient Case Study
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
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.