Is a 10% capsular contracture rate too high for a plastic surgeon to have at his practice?

Question

What should be a normal general rate of capsular contracture when going in for a consult and asking this to the surgeon ?

Ronald J. Edelson, MD · Answer

Ten percent capsule rate is pretty much what I would expect from silicone gel.  Saline implants have a considerably lower incidence of capsule, in my experience.

Gerald Minniti, MD, FACS · Answer

Hello,After implant rippling, capsular contracture is the most common complication of breast augmentation. Reported rates of 10% are considered the average, but many surgeons who practice based on the best scientific evidence have routinely lower rates, usually around 2%.  There is great controversy among surgeons about this subject that has led to rather heated discussions at meetings.  Doctors are people too, and there is a general tendency to avoid change, even when science tells us there may be a better way of doing things. If you want breast augmentation and are willing to do what it takes to minimize your risk of capsular contracture, here is a list of things to focus on with your surgeon:1. Dimensional Planning.  Breast implants are no different than shoes.  There is an optimal size implant for your anatomy. Try to not deviate too far from it to achieve your aesthetic goal.2. Inframammary incision.  There's been enough clinical studies to show that this produces the lowest risk of contracture among the available incisions.  Peri-areolar incisions carry the highest risk, yet are still commonly performed, especially in the Southern California area.3. Sub-pectoral implant placement. 4. Form-stable, textured and shaped implants. These devices have a very high performance record based on the clinical studies used for FDA approval.5. The surgical technique should be meticulous, electro-cautery only surgery, without blunt dissection. First described by Dr. Tebbits, now taught in the Allergan Academy for surgeons around the country, and known as the '24 hour' or 'flash' recovery by surgeons who advertise on their websites, this technique yields a quick recovery with the least discomfort, and a low risk of capsular contracture.6. A 'no touch' method of implant delivery into the pocket.  This minimizes the risk of implant contamination during surgery, and provides a means of rapidly placing the implant into the pocket with little physical stress on the implant. Many surgeons choose to use a pre-fabricated funnel-like device.If these steps are taken, you will unlikely need narcotic medication during your recovery,only high strength ibuprofen is necessary.  Additionally, those surgeons that really embrace this practice will give you exercises to do the day of surgery, which includes lifting your arms above your head.  Most people are back to all of their daily activities within 72 hours.Best of luck!

Bruce Landon, MD · Answer

Thank you for your question. I would say a 10% capsular contracture rate is average although most plastic  surgeons do not know what their capsular contracture rate is unless they have been tracking a group of their own patients long term. There are many techniques a plastic surgeon can take during surgery to reduce a patients chances of a capsular contracture. I would suggest you consult with a well know Plastic Surgeon and discuss your concerns and ask what his or hers techniques are for reducing capsular contracture rate. Best of luck to you.

Neal Handel, MD · Answer

Ten percent is not an unreasonable rate for capsular contracture.
It depends, of course, on how long the surgeon does follow up on his patients.
The longer implants are in place, the higher the rate of contracture. Most plastic
surgeons really don’t know their contracture rate – because they do not see the
patients for very long after surgery. Many surgeons under estimate their contracture
rate.

Wesley G. Schooler, MD · Answer

CC rates are variable and dependent on technique (above or below the muscle, through the nipple or armpit vs under the fold) and type of implant. In studies, the rates were over 20%with one brand of implant and even higher when placed above the muscle and done through a nipple incision. The good news is now all 3 implant companies have guarantees for implant replacement if early contractures occur.

Richard Chaffoo, MD, FACS, FICS · Answer

Thanks for your question. The simple answer is no. While most studies in our literature have demonstrated capsular contracture rates of up to and higher than 10%, this number is meaningless to a prospective patient. The problem is no surgeon knows whether you will be in that 10% who develop a capsular contracture or the 90% who do not. If it happens to you it's obviously 100%. In the end, the only way to avoid capsular contracture is to avoid breast augmentation. Find a plastic surgeon with whom you are most comfortable and is board certified by the American Board of Plastic Surgery. Best of luck.

Marcel Daniels, MD · Answer

The problem with your question is that the answer is variable: it varies from surgeon to surgeon and it varies with the surgical approach (eg. going thru the nipple has a higher contracture rate). Your best bet is to interview a few experienced breast surgeons and pick the one who seems best suited to your needs. Good luck!

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for your question but most surgeons probably don't know their real rate particularly if they are in Calif as follow up after a year or two frequently does not happen as patients move.  Immediate contracture rates should ideally be below 10% and even lower as in my practice but I would not use that as a criteria alone Dr Corbin

Brooke R. Seckel, MD, FACS (retired) · Answer

Generally speaking early studies of the new silicone breast implants done several years ago reported a 9.6% rate of capsular contracture.  Thus a 10% rate is in line with early studies.More recent studies have shown a reduced rate of 6.5% and when implants are placed beneath the chest muscle that rate is reduced to 2.2%.

Is a 10% capsular contracture rate too high for a plastic surgeon to have at his practice?

Answers (9)

More Breast Augmentation Questions

When will my muscles relax after Breast Augmentation?

Under BlueCross BlueSheild Carefirst program, can Breast Reductions not be deemed medically necessary until post op evaluation?

Body rejection of implants.

Animation deformity - how common is it?

I have nerve damage after breast augmentation surgery. Would a revision help?

WE SEND PRETTY
EMAILS