How high are the risks percentage wise for capsular contracture?

Thank you for your excellent question, and I can understand your apprehension.  Capsular contracture takes place in all breast augmentation cases, and is a process by which the body places scar tissue around the implant, "walling if off" from the rest of the body.  Contracture is graded on a scale of 1-4, where grade 1 indicates a breast that looks and feels like a normal breast, grade 2 indicates a breast that feels firm, but has no visible alterations/changes, grade 3 feels firm and looks altered, and grade 4 has associated chest pain.   The severity of the contracture largely determines if any additional surgery is needed to correct it (normally grades 3 and 4).  Though there is no certainty as to what causes capsular contracture, the leading thought is that contamination of the implant with bacteria may predispose to higher grades.  This is the reason that surgeons use minimal touch techniques with breast implants to lower this contamination risk.  Though contracture occurs in all cases, the vast majority of implants do not experience the complications of the higher grades.  Hope that this helps. 

With
the new technology involved in gel implants, the data that capsular contracture above and below the muscle is essentially the same. Bacteria are thought to
be one cause for a contractor. Therefore anything to minimize exposure to
bacteria during the case helps minimize capsular contracture. I prefer an
inframammary fold incision to a periareolar fold incision for this very reason.

Capsular contractures are a greater risk when implants are placed above the chest muscle rather than below it.  I think this is due to two things - first, when placed under the muscle, your daily activity using the chest muscle causes this muscle to massage the implant below it.  More importantly, however, I believe that significant capsular contractures occur in response to bacteria.  There is an abundance of bacteria living within the breast tissue.  By placing the implants below the muscle, the muscle forms a barrier between the implants below the muscle and the breast tissue above where the bacteria live.  Since I started placing implants below the muscle 15-18 years ago, I have almost eliminated capsular contractures from my practice.  I rarely see them anymore.  So, to sum up, from my perspective, if you are a good candidate, then placing the implants below the muscle is your best defense against forming capsular contractures.

Great question and the bottom line is that there is no way to determine your exact risk for complications after breast augmentation. Every person has different risk profiles and certain women seem to have a higher rate of contracture irrespective of technique used. The discussion of whether the risks are worth it for you will depend on your consultation with a plastic surgeon. Every procedure has risks and benefits and you primarily have to decide if the benefits outweigh the risks for you. In general, breast augmentation is a highly satisfying procedure with low risks. #PlasticSurgery #BreastImplant #BreastAug #Shouldigetsurgery #sugeryprep 

While at one time this was a common problem, thankfully, capsular contracture, in most surgeons recent experience is rare complication.  My personal experience mirrors that of Dr. Sieveking, and others. The use of modern devices and techniques have made this a less than one percent type of problem.  Plastic surgeons face this problem sometimes after implant reconstruction used after mastectomy, especially in irradiated patients, but rarely in augmentation patients.