Who can develop a capsular contracture?

Thanks for the question.
The short answer is the scar tissue from your rhinoplasty is unlikely to be related to your risk for capsular contracture and anyone can get capsular contracture after breast augmentation.
It is not completely clear what causes capsular contracture.
Capsular contracture can occur as soon as 4 weeks after breast augmentation surgery. A capsule forms around any foreign body placed within the human body - this is a normal occurence and all breast implants have capsules around them shortly after surgery. The capsule is made of the following:

Blood vessels
Collagen
Myofibroblast

The capsular contractures can be identified as to a scaling from mild to very severe. The classis scale used by Board Certified Plastic Surgeons is the Baker classification.
* Baker I capsule is a soft breast without significant scar tissue.
* Baker II capsular contracture is a palpable scar tissue around the implant; however, not visible.
* Baker III capsular contracture is associated with visible and palpable hardening, leading to a deformed shape to the breast.
* Baker IV capsular contracture, most severe, is associated with hardening, palpable, visible and often a cold, hard breast that is very painful to even mild palpation.

Usually people with Grade I or II implants don't even notice the capsule.
Most surgeons agree there are things that predispose people to severe capsular contracture. These include:

infection or contamination of the implants
bleeding around the implant
previous capsular contracture problems
rupture of silicone implants (typically the older styles)

In our San Francisco area practice we use techniques to significantly reduce the chance of our patients having these problems.
We have also utilized techniques (like the placement of acellular dermal matrixes) to help patients who have had significant capsular contracture and have been referred for treatment by their original surgeon.
I hope this helps.

Hi there-
There are two questions here...
First of all, there is no reason to believe that scar tissue formed after your nose surgery means anything at all if you were to have surgery on your breasts (or anywhere else on your body, for that matter).
Secondly, with regard to capsular contracture, here's what you need to know...
First the facts:
ANYONE can develop capsular contracture after breast augmentation, and in fact, given enough time after surgery, almost everyone will. In other words, it is best to understand that if you have your implants long enough, they will become tightly encapsulated- the key is to keep this from happening for many years, which we are successful at accomplishing in the vast majority of patients.
Because no one really knows for sure what causes capsular contracture, it is not possible to completely prevent it- it is (for now) going to be a risk of this type of surgery for every woman who has breast augmentation.
Nonetheless, breast augmentation remains one of the most commonly performed aesthetic procedures with the highest rate of patient satisfaction in the world because these problems are fairly rare.

The rhinoplasty related complications or problems that you have described would not or should not be rindicative or predictive of any complications with your breast augmentation and mastopexy procedure.

Complications do not happen often but are related to the quality of the surgeon. So make sure you see a board certified plastic surgeon who has nice before and after results.
Capsular contacture is unpredictable and happens in about 7% of the patients who undergo breast augmentation. Some surgeons have higher percentage some lower. That is just a national average. There are things that I do in the operating room and outside after your surgery to help reduce the capsular contracture rate.
Hope that helps.

Anyone with implants can develop capsular contracture, and seemingly at any point postop. We really don't know what causes it so giving advice on how to avoid it is difficult. The only thing I know for sure will cause a capsule is a post op hematoma. For this reason, I try to keep meticulous hemostasis in surgery and to see all my breast augmentation patients within a day or two of surgery. Anyone with a possible hematoma is reexplored immediately. They are rare but, certainly will cause capsules down the road.

Scarring on the nose after rhinoplasty is not related to the type of scarring that occurs with capsular contracture. Most cases of contracture occur only on one side, so it is not simply the body's reaction to the implants either. It does seem to be slightly more common with silicone implants, and implants above the muscle. However, using good techniques it is not common, and the published statistics of more than 10% are far greater than what most of us see in practice.

It is difficult to predict who will develop a capsular contracture. The cause is believed to be multifactorial in nature.

Breast implant scarring - capsular contracture has nothing to do with your nose scarring.
The rate of breast implant contracture is under 10% and although in most cases has no identifiable causes it is seen in higher frequency with infection,blood in the pocket, contamination of the pocket with either glove powder or microscopic gown or gauze fragments.
Unless you are not willing to accept a less than 1 in 10 chance of scarring you can go ahead and have the operation.
Good luck
Dr P Aldea

A capsular contracture (development of scar tissue around an implant) can happen to any one. Most surgeons quote the incidence of this happening at between 5-10%. Unfortunately, there is nothing you can do to prevent this from happening. The one postop complication that can cause an increse in the potential for this to ocurr is bleeding or the development of a hematoma. This is why it is important to have meticulous hemostasis before closing your incisions. If you do develop a capsular contracture, you may require an additional surgery to remove or break up the scar tissue. The necessity of whether you would need this surgery would be decided between you and your surgeon.
The fact you have scar tissue on you nose from a rhinoplasty, does not predict whether you will develop a capsular contracture. Talk to a board certified plastic surgeon about whether you are a good candidate for breast augmentation surgery and feel comfortable that all of your questions and concerns are answered prior to proceeding.

The simple answer is anyone can develop capsular contracture. But it is a statistical question of the percentages who do in all augmentations. Studies have shown the capsular contracture rates are very low -- in the single digits.
If it happens to you, then it is 100% for you, and you would be very unhappy. We as plastic surgeons can not predict who is going to have a capsular contracture. Please go see 3 boarded plastic surgeons in your area to discuss in greater detail, or until you fully understand the causes and treatments.
Regards from Miami