What's the best method to treat capsular contracture?

Capsular Contraction is the #scar tissue that forms around the #implant is a natural response to a foreign object implanted in the body. The capsule can tighten and squeeze the implant making it firm. This is referred to as capsular contracture. This firmness (breast capsule) can range from slight to very hard. The firmest ones can cause varying degrees of discomfort or pain. #CapsularContracture can occur in one breast or both. Those experiencing this are candidates for Breast Revision Surgery. An implant revision or exchange intends to replace the damaged implants with new silicone or saline filled implants with newer technology. econdary breast surgery can be complex and needs to be done by an experienced plastic surgeon. The specific procedure to be performed will depend on the complications experienced and the condition of the implants.

It’s normal
for patients to form capsules around breast implants following breast
augmentation procedures.These capsules
are necessary to hold breast implants in proper position and, without capsule
formation, implants tend to migrate.Unfortunately, in a small percentage of patients, capsules become
exuberant.Under these circumstances,
they can cause implant distortion, implant hardening, implant migration, and
pain within the breasts.Unfortunately, the mechanism for
capsule formation is poorly understood.In some cases, it may be related to infection, while in other cases,
bleeding may be the cause.Regardless of
the precipitating event, inflammation appears to be a critical component.It’s important to note that the rate of
capsular contracture is significantly lower when breast implants are placed
beneath the pectoralis muscle.When capsule formation is relatively
mild, implant massage may occasionally improve the condition.Unfortunately, in many cases the problem
becomes progressive and the deformity worsens.When severe capsules occur, surgical
intervention may be necessary.In this
case, a procedure known as a capsulotomy can be performed.This procedure simply releases the capsule
and effectively increases the pocket size.In other cases, patients may undergo a procedure called a capsulectomy,
in which the capsule is actually removed.In some cases, removal of the implant and placement in a different
location, either on top of the muscle or below the muscle, may be necessary as
well.When these procedures are
performed, it’s not unusual to replace the current implant with a larger
implant.It’s important to wait for at
least six months before proceeding with surgical intervention to allow the
inflammatory response to diminish.The recurrence rate following these
procedures is relatively high and, for this reason, many surgeons utilize drugs
such as Singulair and steroids to decrease the inflammatory response.The use of these agents is somewhat
controversial and no scientific studies at this time have demonstrated
decreased rates of capsule formation.Once a severe capsule develops, it’s
important that the patient maintain close contact with their surgeon.Their surgeon should be able to formulate a
treatment plan that addresses their anatomic findings and hopefully achieves
their aesthetic goals.

Hello! Thank you for your question! Physical examination will determine if you have capsular contracture. The look and feel of hardness surrounding your implant is seen and/or felt. It may also cause distortion of your breast. What has caused it will be in question. Your surgeon will likely recommend implant massage and may add the medication Singulair.  It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall.  Irrigating with certain medications may also be if benefit. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc). Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

There is no definitive answer to this question other than the best way to prevent capsular contracture is to remove the implants and leave them out. That having been said. I would advise capsulectomy with implant removal and replacement.

Simply removing and replacing the implants will not solve the problem of capsular contracture. I treat breast capsular contracture using a combination surgical and non-surgical approach including capsulectomy, implant replacement, topical protocols, and oral medications.