What is Capsular Contracture?
Capsular contracture is a possible complication of breast implant surgery. A breast should be soft, flexible, and drape naturally, even if it is a reconstructed breast that was surgically created after a mastectomy (removal of the breast). If you have saline or silicone breast implants, capsular contracture can cause your reconstructed breast to shift, change shape, or feel quite hard. If this happens in your case, you can get treatment to correct the problem. While it is normal for every patient to have some scarring following any type of surgery too much is not a good thing. A capsular contracture is caused by an abnormal response of the body’s immune system, reacting to the breast implant as a foreign object. It occurs more often around silicone, rather than saline implants. Women may experience a capsular contracture in one breast or both, and the longer an implant is in place, the greater the chance that a contracture will develop.
How Can I tell if I have a Capsular Contracture?
In the case of breast augmentation surgery a layer of scar tissue grows around the implant causing it to feel hard, shift out of natural alignment and cause discomfort. The scar tissue can form around the whole implant and starts to squeeze it as the connective tissue thickens in an attempt to isolate the foreign object and keep it separate from the rest of the body. Ordinarily the capsule will remain thin and not cause any problems but in the case of capsular contracture this layer of protection grows increasingly thicker until the breast is hard to the touch and uncomfortable. You may notice that your implant has shifted higher on the chest or shows some other visible sign of abnormal positioning. The diagnosis of capsular contracture can often be determined by your surgeon on exam alone. However, imaging studies can offer further insight, with MRI being the most accurate test in making the diagnosis.
Can capsular contracture be avoided?
Smoking before any type of surgery is discouraged and can be a contributing factor to capsular contracture. Smoking increases the risk as it decreases the oxygen levels in the body thereby inhibiting and delaying healing. If you smoke, you will need to quit smoking at minimum 3 weeks prior to surgery for the best chance of quick healing and a good result. At Posh Plastic Surgery, this is mandatory.
Bacteria entering the surgery site is a contributing factor to contracture complication, and most surgeons use what is called the “no touch” technique to minimize the introduction of bacteria. The surgeon washes and rewashes his hands as required throughout the surgery and has minimal contact with the implant and the chest wall skin. Prior to the insertion of the breast implant into the pocket, triple antibiotic preparations are flushed into the pocket and implant to minimize the chance of bacteria surviving in the surgical site. Further reducing the risk of infection and capsular contracture, some surgeons utilize a Keller funnel to place the implant in the pocket. This no-touch technique involves placing the sterile implant into a pastry funnel type device, where it can then be squeezed into the breast pocket with minimal contact.
If nothing can be done to stop thickening of the scar tissue then the only option may be opening the capsule (capsulotomy), or removal of the capsule (capsulectomy), with implant replacement. A capsulectomy is surgery that removes the stiffened capsule, and the implant may be replaced during this procedure for best results. A capsulotomy is surgery to loosen the scar tissue by slicing it, which allows for expansion.
Surgery may not always be needed, however, as conservative methods such as massage, ultrasound, and medications may help the stiff capsule relax. Talk to your doctor about your options.
At Posh Plastic Surgery, Dr. Sofia Kirk performs breast augmentation with all the precautions available to prevent capsular contracture. Choosing board-certified Dr. Kirk is your first step in enjoying a complication-free breast augmentation surgery. Schedule a complimentary consultation by calling Posh at 904-260-2001 or by filling out the convenient form below.