After 4 times having capsular contraction with shooting pains, burning and itching, what do you suggest?

Hi amydonnamaria,

Capsular contracture is a condition that occur when the tissue surrounding the implant area tightens and contracts around the implant, resulting in unnaturally firm, distorted breast shapes that can sometimes be painful.

Correction generally requires removal of the implant, removal of the scar tissue, pocket repair, and fat grafting or new implant placement. If caught early enough, capsular contracture can sometimes be improved with medication and massage techniques.

We do not know what exactly causes capsular contracture but we do know several evidenced based techniques that can be used to prevent it from happening in the first place and to help prevent it from coming back for revision cases.

If you are concerned, it would be best to visit your plastic surgeon for proper assessment. Only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

 

Recurrent capsular contracture like this is a tough problem. I would consider explantation of the implants or capsulectomy with insertion of new implants as well as the insertion of acellular dermal matrix. This seems to be very helpful in preventing recurrent capsular contracture.

Dear Amy
I am so very sorry that this has happened 4 times to you.
The reasons for repeated capsular contracture I sure you have googled already are many! But more often a combination of your tissues ( bleeding/ collections post op), surgical techniques ( where the implant was placed, what type of implant/s, in the revision surgies was the whole capsule removed, did the surgeons change into a fresh tissue plane), potential low grade infection, smoking etc etc..
However after 4 operations with implants, you have to very carefully consider your options which I believe are:
1. Remove the implant completely, accepting that it just didn't work for whatever reason.
2. The remaining breast tissue may be enough to perform an uplift with the addition of fat transfer. This may require staged operations.
3. If you definitely need/ want another implant I 100% agree with a comment by JJ. Staino ( see below) there is very good evidence from over 38-40years in the medical literature that a Polyurethane coated implant would be the best.
I would also recommend your next surgeon send some of the capsule and if there is fluid around the implant off for histological and bacterial analysis.
I hope this helps in some small way.
Kind regards
Mr G

 

Hi Amy, 
It is always disappointing to experience problems after a surgical procedure. I am sure you are now well informed about capsular contracture, so I will not bother you explaining that as frankly, it is very controversial. 
Where your implants over or under the muscle? Evidence shows that going under the muscle reduce the capsular contracture rate. What type of implant do you have? Different brands have different capsular contracture rate. Smooth implants also have low capsular contracture rate. 
There are some options for you at this time: remove the implant and restore your breast with fat? Remove the implants and perform a auto-implant (no device used) mastopexy +/- fat? Change implant with Motiva or Polyurethan implants? 
I hope you get good advice from the surgeon you will be consulting with and I wish you good luck. Remember, nobody can guarantee you won't get a new capsular contracture if an implant (any) will be used. 

Hello Amy,Capsular contracture can present a real problem, because it is caused by the formation of scar tissue around the implant and the more operations you have, the more scar tissue is created and so it gets worse and comes around quicker the more operations that you have.  For this reason, you should limit the amount of operations that you have as much as possible.It is really tough if you have had four operations already.  I am not sure what you are asking with your questions, because if you are having pain and burning and itching, then I would recommend that you go back to your surgeon to check that it is all OK.If you are concerned that you are getting another capsular contracture and are considering further surgery, then you could consider polyurethane foam coated implants, as these have a much lower rate of capsular contracture compared with silicone implants and you can read more about them on my website.Good luck and I wish you all the best.

Hello, I am so sorry you've had to struggle with this issue. Capsular contracture is a known complication of having breast implants and unfortunately, with each revision surgery your risk of repeat contracture just about doubles!
Knowing that you have had multiple recurrences, even without knowing exactly how they were treated before, many surgeons will tell you that the best course of treatment may be to completely remove the implants and the capsules and allow your body to heal. You may choose to re-do your breast augmentation 6 months to 1 year later or you may decide you don't want to risk this again and have a breast lift with or without fat grafting to shape your breasts.
If your previous treatments did not fully remove the capsule or use acellular dermal matrix or create a brand new pocket for your implants (which should also be changed every time you are treated for capsular contracture - all the manufacturers have warranties and financial assistance that should help defer some of the costs), you may be a candidate for this which would allow you to keep implants in. HOWEVER, that is up to your surgeon after a thorough clinical exam and possibly some imaging.
It's best to present for your consultation with the operative notes from your previous capsular contracture treatments because this will help guide your surgeon. 
Best of luck with this! - Dr. Leong

Sorry to hear about your contracture issues.  Your best option now is to remove the implants with the capsule. Insert new implants with acellular dermal matrix or Galaflex. This approach has been successful in preventing recurrence of capsular contracture.