Capsular Contracture, the hard scarring seen with up to 15% of breast implants is seen MORE in cases where there was excess blood in the breast pocket (aggressive blunt dissection or post-operative bleeding), foreign bodies, or microbial contamination or later sub-clinical infection. Placement of implants over the muscle (aka "overs") is associated with a higher rate of capsular contracture most likely due to colonization from bacteria in the breasts ducts.
Once capsular contracture occurs, it tends to occur with increasing frequency with each operation. Conservative, nonsurgical measures to treat capsular contracture have been at best a hit or miss proposition. Releasing the hold of the scarring by putting cuts in it (CapsuloTOMY) is associated with a very high rate of recurrence. Removing of the whole scar (Total CapsulECTOMY) is associated with a high rate of complications. Removal of most of the scar tissue (Subtotal Capsulectomy) with placement of a NEW implant (one that may not have a bacterial film on it) in either a sub-muscular pocket (if it is not there already) OR in a new pocket UNDER the scar, if it was there already) has been the best way to lower the chances of new capsular contracture. Recently, increasing amount of information has ALSO supported the addition of Strattice to this operation to FURTHER reduce the odds of recurrence of capsular contracture.
Review this strategy to what you had done and decide what you should have done next.
Peter A Aldea, MD