Can capsular contraction be the caused by years of breast squeezing? 7 years post breast implant revision.

Question

It has been 7 years since I got (2nd set of) implants. All of a sudden one has grown very hard. I had capsular contraction with my first set of implants and that is why I had them replaced (after 16 yrs). Could capsular contract be caused by rough handling? My husband squeezes the daylights out of my breast (always the same one) in the throes of passion. Would this treatment over time cause capsular contraction? Would bia-ALCL cancer cause the sudden capsular contraction? Thank you.

Jed H. Horowitz, MD, FACS · Answer

hello lolamc This is a condition where the capsule around the implant thickens and squeezes the implant making it hard and often changing the shape and position of the implant. It is more common in nicotine users (e.g. smoking or nicotine patches or gum). Effective treatment of the capsule frequently involves completely removal of the capsule (capsulectomy), and occasional incisions in the capsule may be somewhat helpful (capsulotomy). In the past, closed capsulotomy, in which the breast is squeezed until the capsule breaks, was used. Currently, most doctors avoid this technique because of complications associated with the technique and because the implant companies will void their warranty if this technique is used. At times it is necessary to change the position of the implant, either above or below the muscle, depending upon the initial position, changing the implants themselves and, on occasion, the use of Acellular Dermal Matrix (ADM) may be required to prevent continued problems. Although the published risk of capsular contracture is approximately 9-11%, in our practice it is somewhat lower after initial implant placement. Once capsular contracture occurs, the risk of problems with secondary surgery rises to between 25% and 40%. The use of Singulair and Vitamin E may be of benefit. If you had a Sientra Textured Implant placed as a primary procedure and a contracture occurs in the first two years after primary augmentation, then their implant warranty may apply.

Shlomo Widder, MD · Answer

Dear Lola,   Sorry about your problem. Capsule contracture can occur years after the original surgery due to infection or bleeding.  1. Infection. I always recommend to my breasts augmentation patients to take antibiotics before any procedure that can introduce bacteria into the blood stream , like dental manipulation, colonoscopy etc. The bacteria can settle on the implant and cause 'Biofilm' , resulting in severe capsule contracture, that requires capsulectomy (scar excision) and replacement of the implant. 2.Bleeding. Any small tear of the pectoral muscle in the pocket can cause bleeding and inflammatory reaction to the bleeding, resulting in capsule contracture. I do not believe that rough handling or squeezing of the breasts in 'throes of passion' can cause it,  but, abrupt lifting of luggage  or intense weight lifting in the gym can do it.  As far as ALCL, which is extremely rare Lymphoma of breast,  it presents itself , usually,  as large seroma that appears years after the breasts augmentation procedure and is associated mostly with textures implants. Capsule contracture is not part of the presenting signs.   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after picture of redo breasts augmentation, to make sure that they are numerous, consistent and attractive.                                 Best of luck,                                                    Dr Widder

Richard Baxter, MD · Answer

In general squeezing the breast should not cause a capsular contracture many years after implantation. If there was a muscle tear or trauma enough to cause bleeding around the implant, then it might but you would probably know if that happened. BIA-ALCL presents as significant swelling due to a fluid accumulation around the implant.

Daniel Barrett, MD · Answer

Dear Lolamc,Capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Curtis Wong, MD · Answer

as the general risks of contractures are 20% over the lifetime of the patient.  If you have appreciated changes, you should see your surgeon for an evaluation and for options on how to best manage your problem.

Can capsular contraction be the caused by years of breast squeezing? 7 years post breast implant revision.

Answers (5)

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