Concerned About Capsular Contracture Risk

Is it possible to get capsular contracture again and again, despite all efforts? I am 20 years old. I have A cup and I can't even imagine to explant once I am implanted. What are the chances I will only be replacing breast implants and never get CC in my life? If the implants bleed, can this cause CC in the future? Can mouth infection from dental cleaning and chronic tonsilitis cause CC too? If I replace implants every 10 years, do I need to have capsule removed every time with each replacement?

Doctor Answers 5

Breast implant capsular contracture risks

There are four factors we know lead to capsular contracture:

1. Gel / silicone implants have a higher rate than Saline.

2. Under the muscle placement has a lower rate than over the muscle.

3. Bleeding / bruising postoperatively can lead to higher capsular contracture rate.

4. Infection of the breast implant can lead to contracture.

A brief explanation of the above:

Silicone gel implants have a higher rate of capsular contracture than saline. The thought is the higher capsular contracture rate is because of a phenomenon called gel bleed, where the gel inside microscopically "leaks" out and irritates the capsule. The newer generations of gel implant are "cohesive gel" to try and help prevent this.

Under the muscle has a lower rate of capsular contracture, whether gel or saline.

Bleeding and infection are risk factors. I use a triple antibiotic wash during the surgery, which has been shown to reduce capsular contracture. You also receive IV antibiotics and take afterwards. Prophylactic antibiotics for dental work has been discussed. Many plastic surgeons feel that a low grade infection can be present when the capsule thickens -- your breast isn't red and tender or looks infected, but there is what we call a "low grade infection", which causes a slow hardening.

We don't understand all of the factors with implants and why they harden. I do a lot of revision breast implant work, and I see many patients with a soft breast on one side and a hard one on the other.

I hope this helps!

Palo Alto Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast implants, infection, capsular contracture prevention

I have found that textured implants decrease capsular contracture. They are rarely seen in my practice. However, no one can guarantee a certain result. Mouth infection or dental cleaning can lead to implant infection, necessitating removal, so I recommend women with breast implants take prophylactic antibiotics before going to the dentist. No the capsule does not have to be removed if you replace your implants.

Steven Yarinsky, MD
Albany Plastic Surgeon
4.8 out of 5 stars 25 reviews

Capsular contracture risk factors

The historical factors summarized by Drs. Greenberg and Yarinsky are quite right. In addition, the concept of "biofilms" is getting more attention. Infection is usually associated with redness, swelling, heat and pain, however the "biofilm" provides for an infectious cause which occurs without the usual stigmata. One of the US implant manufacturers has a protocol for microbiological analysis of samples of capsule removed at the time of revisional surgery. It is their contention that "colonies" of atypical bacteria, instead of the planktonic form, which may be released from dental procedures contribute more to recurrent capsular contracture.

Don't fret. In the main, the rates of capsular contracture range between 5-20%, so 5-20/100 women will have a secondary procedure, because of firming around an implant. Many of us who use Alloderm (acellular cadaveric dermal graft) for breast reconstruction have noted a lower rate of capsular contracture in these breast cancer patients. So there are many different etiology (causes) of CC and also interest in understanding the pathological process.

When the silicone gel implants were released in the US in 11/06, the FDA recommended that women have a regular schedule of MRIs at 3 years and every 2 years thereafter. If your implants are still soft, the nipples are in an appropriate position and you are content with the size, it isn't necessary to exchange them, every 10 years. MRI will document whether they remain intact or fail. If you do require reoperation, the amount of scar capsule removed will depend on the surgeon's evaluation. good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Capsular contracture

There is a definite risk for a capsular contracture to develop but no one knows for sure why they occur.  The statistics support the fact that implants are not a "lifetime"  product and sometime down the road you will have at least one more operation.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

VIDEO (Click HERE) Concerned About Capsular Contracture Risk

These are great questions but unfortunately we do not ahve thew answers. Capsular contractures are unpredictable. They can form unilaterally or bilaterally and may occur immedieately or delayed. Yes, they have been reported after dental cleaningss and tattoo, etc.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.