Bigger silicone breast implants more prone to capsular contracture?

The size of the implant does not influence the likelihood for contracture...UNLESS...you get an implant so large that the surgeon has to cram and force it into the space, thereby creating excessive trauma and bleeding, which do contribute to contracture.

But implant size does affect other things that can be even more problematic than contracture, such as malposition, tissue thinning, and skin stretch. Those are reasons enough not to put in any larger of an implant than ideally fits within your tissue. As much as women hate capsular contracture, it is not one tenth as disconcerting as having implant visibility and rippling, both of which occur more often as large implants create the tissue over them to thin with time.

So...implant size should not be subjective. You should be measured and receive the implant that fits your tissues. In all of surgery, there is no other prosthesis inserted into the human body in which the patient is allowed to dictate the size. Choose the implant that fits, and you will have the best long term result.

S

Dear Sam 79

There is no definite findings in the literature of a greater incidence of capsular contracture of larger vs smaller silicone implants.
A recent study showed an incidence of 2 to 5 % capsular contracture in relation to silicone implants. There was a slight increase in rate with the Allergan implants but i would not say that this was significant.
Capsular contracture can occur any time after surgery but is most common in the first 3 to 6 months after surgery.

With Warm Regards,
Trevor M Born MD

The early days of breast implants was largely focused on silicone implants due to their more natural feel. All implants were placed into the subglandular position. Unfortunately, as the use of these implants progressed they were found to have a substantially greater risk of capsular contracture over saline implants.
Many different techniques were tried to prevent the capsular contracture including the use of saline implants. Eventually it was determined that if the implant was placed in the submuscular position (being fully covered by muscle) then the capsular contracture rate not only decreased for silicone implants but it equaled saline implants which also decreased.
Further refinements in technique determined that if the implant was only covered by the pectoralis muscle (subpectoral) and therefore approximately 80% of the implant was covered they still maintained low capsular contracture rates. Which is where we are today.
Size has nothing to do with the capsular contracture rate but does carry other issues such as thinning of the overlying breast tissue. See the article below for a good history of implants.