Reducing Capsular Contracture Risks
Article by David N. Sayah, MD, FACS
Beverly Hills Plastic Surgeon
Although occurring in only about 10 percent of surgeries, capsular contracture remains the number one
complication seen in breast augmentation. This development of excess scar tissue can be severe enough to require surgery to repair.
Fortunately, there are several ways to reduce the risks of capsular contracture during the surgery itself.
Time and again, post-surgical results indicate that capsular contracture is more prevalent in subglandular placement than it is in submuscular placement. This is true for both silicone gel and saline implants. For patients who already have capsular contracture and are undergoing breast
surgery revision, moving an existing surgical pocket to under the muscle is one of the more successful approaches to preventing recurrence, along with other proactive measures.
Another factor in the development of severe scar tissue is the type of implant used.
Silicone gel implants have a higher chance of becoming encapsulated than saline implants. However, implants that have a
textured or polyurethane-coated shell carry a lower risk factor of capsular contracture whether or not they are silicone. In either case, although the specific cause of capsular contracture is uncertain, limiting implant handling and contact with the chest wall prior to insertion, as well as thorough antibiotic irrigation prior to placement similarly help mitigate the risks of excessive scar tissue development.
Correcting Capsular Contracture
If, despite these efforts, excessive scar tissue does develop, breast surgery revision can be performed
to either release the capsule or remove it completely. Implants may be replaced during breast surgery revision as well; however, having had capsular contracture previously does present an increased risk of development a second time unless proper precautions are taken.