Right Breast Capsulated After 20 Years - Why?

Question

After 20 Yrs my Rt Breast Suddenly Capsulated

Gregory A. Buford, MD, FACS · Answer

This is really a hard question to answer.  However, the reason why they did is less critical than the fact that encapsulation is actually relatively straightforward to correct.  Most PS's will simply remove some or all of the hardened capsule, wash the pocket out extensively with antibiotic solution, and then replace both implants.  By doing so, the results can often be quite pleasing and the downtime is next to nothing.

	I hope that helps!

Otto Joseph Placik, MD · Answer

Schedule a consultation with a board certified PS and plan to have the implants replaced.  The cause of CC is unknown but if your implants are giving you problems, it is time to change them.

Thomas Fiala, MD, FACS, FRCSC · Answer

Many times, the exact reason that capsular contracture occurs is never known.

	If there was bleeding or infection recently in the breast, this could be a cause.

	If your implant has ruptured, this could also be a cause.

	I'd recommend getting an ultrasound to check on your implant.  If the capsule is hard, painful or looks asymmetric, those are all reasons to consider the corrective surgery.  Your local board-certified plastic surgeon can help you with this.

Steve Laverson, MD, FACS · Answer

The incidence of capsular contracture increases with the duration of time since breast implants were placed. There are a variety of theories about why this is so, and I have my own personal beliefs, but if yours developed after 20 years, you've gotten good mileage out of those implants by most standards.

Steven Wallach, MD · Answer

Why at 20 years out did you get a capsular contracture?  No one knows for sure.  If it bothers you then get it fixed.

Terrence Murphy, MD · Answer

If your breast implants are 20 years old there is a good chance they are silicone. A fairly recent change in silicone implants 20 years makes me wonder as to whether you have had a leakage of the implant. Consultation with a reputable experienced breast implant surgeon is a good idea and investigation including an MRI may been helpful. If however you are considering surgery to solve the problem having an MRI may be unnecessary and going ahead with an operation to release or remove the scar tissue with implant replacement is likely the best course.

C. Bob Basu, MD, MPH, FACS · Answer

As my colleagues have stated, it is difficult to pointpoint why you have manifested with capsular contracture. There are two types of capsular contractures: 1) the ones that appear just a few months or weeks after your initial breast augmentation (I'll call these the "bad capsular contractures") and 2) the ones that appear 10-20-30 years after your procedure (I'll call these the "benign capsular contractures"). The good news is that its fairly straight forward to correct these "benign capsular contractures" as compared to the "bad" players. You will likely require a total capsulectomy and implant exchange. I generally recommend a site change surgery if possible where for instance the implant is transitioned from the subglandular position to a new virgin pocket in the submuscular or dual plane position. this neo pocket has no history of scar tissue. Please visit with a board certified plastic surgeon to learn more about your options.

Babak Dadvand, MD · Answer

There are some known causes of encapsulation such as bleeding, infection, and trauma. However, in some patients, there is no identifiable cause.  This of course is not a great answer if you are dealing with capsular contracture. One piece of information I would want to know is whether you have silicone implants. At 20 yrs the chance of implant rupture is higher and it may present as a capsular contracture as opposed to a saline implant which will just look deflated and smaller.

	Hope that helps

	Dr. Babak Dadvand

Mark Preston, MD · Answer

No one will be able to tell you with certainty why you have developed a contracture, and there is probably not one single factor that underlies all contractures. Regardless of the cause, if the contracture is significant, you should consult with your surgeon and discuss the possible treatment alternatives. 

	
		You can leave the implant as is
	
		you can remove the implants
	
		you can replace one or both implants while doing a capsulotomy


	In any case, if you are returning to the operating room, I would not suggest re-using the 20 year old implant.

Karol A. Gutowski, MD, FACS · Answer

Sorry to hear that you have capsular contracture around your breast . Since we don' t really know why capsular contracture happens, it is difficulty to say why it happened to you right now. One common theory is that contracture is due to a low grade (subclincial) infection (possibly related to biofilms). It is also common in patients who had breast implant reconstruction and had radiation therapy for their breast cancer. So it is unlikely to be due to anything you did. At this point, discuss the options with your plastic surgeon.

Right Breast Capsulated After 20 Years - Why?

Answers (10)

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