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Silicone Implant Contracture: Is It the Patient's Fault?

asked 1 year ago by Colorado Springs9096 in Colorado Springs, CO
Latest answer by Robert L. Kraft, MD
Question viewed 1,122 times
Tags: silicone implant, capsular contracture

I had saline implants for 10 years then one leaked (due to defective valve), deflated quickly, and encapsulated, so I had them both replaced with silicone. Now, a year later, i am experiencing swelling near my armpit, tenderness, and a small fever. My breast on this side has begun to itch, get smaller, and hard, while the other remains fine. my doctor says it is my fault for not massaging them everyday for the rest of my life, and it is a contracture. Is this really all me?

19 answers to Silicone Implant Contracture: Is It the Patient's Fault?

+2

Capsular Contracture is Usually Not Anyone's Fault

Capsular Contracture is thought to be due to many reasons, and possibly a low-grade infection or hematoma.  Implant massage is pretty standard for patients to do post-surgery, but it's not known how important it is to do this to prevent capsular contracture.  I would recommend a 2nd opinion or 3rd opinion before deciding if you need more non-surgical treatment or surgical revision.
Roy Kim, MD

San Francisco Plastic Surgeon
+1

Capsular contracture is no one's fault

Some patients have the propensity to form breast capsules and insufficient scientific data exist at this time to clarify why this is the case. The condition you describe may or may not be evidence of a capsular contracture. There is no evidence that failure to massage the implants is the primary causative factor in capsule formation.
Robert L. Kraft, MD

New York Plastic Surgeon
+1

Breast Augmentation and Encapsulation

Thank you for the question. Encapsulation is the process of exuberant inflammatory tissue/scar tissue that builds up around a breast implant. It is unknown why some patients develop this process and others don't. Although there are a lot of “theories”, there is no science that is definitive when it comes to causation. Placing blame or fault is not appropriate and/or helpful. Best wishes.
Tom J. Pousti, MD

San Diego Plastic Surgeon
+1

No evidence that massage works

The concept of massaging breast implants works in theory, not necessarily in practice. There is absolutely no scientific evidence that implant massage prevents capsular contracture. Sadly, some surgeons will do as yours has done and use 'inadequate massage' to blame their patients for capsular contractures. It is wrong and unethical. I suggest that you find another surgeon.
James McMahan, MD

Columbus Plastic Surgeon
+1

Capsular contracture...Who is at fault?

The answer to this question is no one!  We do not really understand capsular contracture its causes or its prevention. What we know is that capsular contracture occurs and it is impossible to predict when and in whom it will occur. I recommend you find a surgeon you are comfortable with and have a discussion of this problem and its possible solutions. As you are having recurrent contractures I would also recommend that you discuss an acellular dermal matrix product such as AlloDerm... more
Paul Vitenas, Jr., MD

Houston Plastic Surgeon
+1

Capsular contracture is not a fault of the patient.

Capsular contracture is a common occurrence after breast augmentation and a process which is poorly understood. There are several known risks to developing contracture including hematomas, infections, and radiation. However, most contractures appear to be idiopathic - meaning we do not know the cause. They are often one-sided and can recur several times. Some surgeons recommend massage and others do not. Simply removing the capsule and replacing the implant is an effective treatment for many... more
David Bogue, MD

Boca Raton Plastic Surgeon

www.drbogue.com

+1

Is never the patient's fault

There are many potential causes for capsular contracture and it is a poorly understood problem.  It is inappropriate  for anyone to blame the patient for this problem.  The goal should be to try and find the solution and make things better, not blame.
Peter D. Geldner, MD

Chicago Plastic Surgeon

www.mygeldnercenter.com

+1

Capsular contracture-it's not your fault

The cause of capsular contracture is not fully understood but it's felt to be due to an inflammatory process that develops due to microbacteria coming into contact with the breast implant. This bacteria can come from the breast tissue itself. Some patients just develop an exuberant inflammatory reaction to the implants and form thick, hard scar tissue (capsule). Most surgeons will coat the implant in an antibiotic solution to help minimize this risk.  Also placing the implant... more
William Bruno, MD

Beverly Hills Plastic Surgeon
+1

Capsular contractire in 1 year old silicone implant replacing 10 year old saline implants.

There are numerous factors that contribute to capsular contracture formation with biofilm formation being one of the most popular explanations. It is difficult to pinpoint the cause for your capsualr contracture  in your description.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Capsular contracture

Capsular contractures are thought to be caused by many different things. There is no scientific support of massage and the avoidance of a capsular contracture.  It may be multifactorial. There may be a genetic component, or  an infectious cause to name a few.  It is thought to be associated with hematomas as well.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Capsular contracture is a multi-factorial problem.

CC is a multi-factorial issue- likely related to bacterial biofilm presence on implants and your own tissue's interactions with a foreign body. Your lack of implant massage likely had nothing to do with this issue. Some surgeon's don't even think implant massage is worth doing (I do...). Seek out the opinion of a plastic surgeon that does revisional cosmetic breast surgery for a second opinion about that to do from here forward.
Scott Sattler, MD

Bellevue Plastic Surgeon
+1

Breast augmentation

Capsular contracture is not your fault.  Not massaging would have not caused your contracture.  I recommend a second opinion.
Shahin Javaheri, MD

San Francisco Plastic Surgeon
+1

Contracture Not Related To Massage

The issue of capsular contracture and massage is very anecdotal, and noone really knows if it works or not.  In theory it makes sense, but there are some surgeons who do not have their patients massage at all and they do fine, while others have their patients massage like crazy and they do fine.  Either group probably has the same rate of contracture, so I would not blame the patient for it.  It is an unfortuante consequence of having surgery again, which can often cause... more
Christopher V. Pelletiere, MD

Barrington Plastic Surgeon
+1

Capsular contracture after breast augmentation- is it my fault?

Complications are complications- they are not anybody's 'fault'.  Recent clinical studies have shown that biofilms may have a causal role in the development of capsular contractures.  These are low grade infections that may result from several different sources, sometimes the patient's own breast tissues.  Regardless, the capsules are not your fault.  Massage used to be considered an important thing to do after certain types of breast augmentation using... more
Claudio DeLorenzi, MD

Toronto Plastic Surgeon
+1

Massage does not prevent capsular contracture after breast implants.

Hi. Besides, you may not have capsular contracture. Swelling near the armpit, tenderness, and fever are not good symptoms. I would get another opinion.
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Capsular contracture is not "your fault" but it is caused by "your body"

Since no one knows exactly why a cc develops, it is unfair to blame the patient as if they could have prevented it.  But the patient needs to know that it is not the surgeon's fauly and that free revisions should not be anticipated.  It is caused by your body's reaction to the implants despite the doctor's best efforts to minimize the risk.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Capsular contracture

I too am less likely to blame a patient for something that has complicated cosmetic breast surgery for many years. We still don't have any firm answers regarding the cause of this problem and the data surrounding the effect of massage isn't all that compelling. You may be in for a revision, but keep in mind that your risk for having this problem again is above average. If this really becomes a serious, recurrent problem for you, you may consider removing your implants altogether. You... more
Allan J. Parungao, MD

Oak Brook Plastic Surgeon
+1

Breast implant contracture

While I generally don't like contradicting another surgeon, it's really not anyone's fault that you developed another contracture.  The current thinking is that contractures occur secondary to a low-grade infection which causes scar tissue around the implant to become thicker.  There is no good data to suggest that massage prevents this from occurring.  You may require another implant exchange, but keep in mind that your chance of developing another contratcure is... more
Nina S. Naidu, MD

New York Plastic Surgeon

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