I had my first BA 2&1/2 yrs ago(Subglandular,285cc,Silicon Implants). The results were great.Just2months ago i started developing Capsular Contracture in my right one. Took anti-biotics and costizon,the breast softened but not for 2long. A month later the right Breast hardened again. Now i have decided to go for a revision surgery for both. My question is what is the best placement method if i want most natural look&less CC rate? Under the Muscle + Silicon + Textured + TearDrop Shape??
Breat Augmentation Revision Due to CC- What is the Best Option, Please Help
Doctor Answers (6)
Treatment options for capsular contracture
Capsular contracture can be difficult to treat. If your current implant is under the gland, changing the pocket to under the muscle will certainly decrease (but not eliminate) your chances of recurrent capsular contracture. Traditional teaching is that saline has a lower capsular contracture rate than silicone, but in Australia no one uses saline implants! Perioperative antibiotic therapy is important, with recent evidence suggesting that low grade implant infections can cause capsular contracture. The Brazilian polyurethane coated implants from Silimed have some of the lowest published rates of CC - another factor to add in to the mix. The final thing which I think contributes is size - make sure you the implant being used isn't too large for the soft tissues of your chest.
Capsular Contracture Best Option for Treament
If you implants are subglandular the best option is to put them under the muscle. I don't believe saline or texturing helps that much, and in some cases can make it worse. Sub muscular smooth gel implants are the way to go.
Options for capsular contracture
This is not an easy answer but things that may be associated with lower capsular contracture include: under the muscle, textured, silcone, "no-touch", triple antibiotics, neo-pectoral pocket, inframammary fold approach, possible accolate therapy,etc.. Discuss these options with your surgeon.
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Capsular Contracture and Implant Position
Research has not really demonstrated a substantial difference between textured and smooth implants with capsular contracture. Going behind the muscle has shown a difference, as has the type of antibiotic irrigation used.
I would recommend going behind the muscle with smooth implant saline or silicone and pocket irrigation and maybe prophylactic use of Accolate (which is off label and no studies for its prophylactic use exists).
Use of acellular products may play a role in decreasing capsular contracture, as there is some evidence especially in radiation to resist or decrease the chances of CC.
There is really no way to prevent capsular contracture at the present time. However, an implant under the muscle has alower rate of capsular contracture. Also, textured silicone implants have lower rate of capsular contracture when in a subglandular plane than smooth types. In a submuscular plane, there is virtually no benefit. I would personally perform a capsulectomy, implant removal, and new submuscular implant placement.
Breast Revision for Capsular Contracture
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