How common is capsular contracture and is there a way to prevent it?

Question

After looking through implant revision before and afters, I'm wondering how common capsular contracture is and if it happens to everyone when getting close to the 10 year mark.

Yuly Gorodisky, DO, FACOS · Answer

CC happens in a certain percentage of women and it may occur soon after surgery or much later.  Sometimes a late occurring contracture may indicate an implant rupture or it may be due to an infection. Some women never get a contracture, others get it repeatedly.  When considering breast surgery, you have to consider the risk and the fact that additional surgeries may be necessary.

Adam David Lowenstein, MD, FACS · Answer

Capsular contracture does NOT happen to everyone.  Data from multiple studies has shown contracture rates to be anywhere from 3% to 20% and so this is a problem that requires awareness by both surgeon and patient.  While we cannot tell for certain who is going to have this problem, we DO know some things that can help prevent it including incision site, implant type, and pocket position.  Some of us with very low contracture rates use things like nipple shields and Keller Funnels as well to help reduce the number of our patients that have to deal with this troubling situation.

John J. Edney, MD · Answer

When an implant is placed during the course of a breast augmentation the body and actually forms a lining around the implant creating a barrier between the foreign object and the rest of the body.  Normally this barrier is thin and soft and does not create any change in the appearance of the breast.  This lining is called the capsule.  If this capsule thickens, becomes harder and shrinks in size the breast will feel firmer and possibly change shape.  This shrinkage of the capsule is called a capsular contracture.  92% of capsular contractures will occur within the first 12 months following surgery.  Although the exact cause for a capsular contracture is not well understood there are a few things that seem to be related to this phenomena.  Implants placed under the muscle have a lower incidence of capsular contracture than implants placed above the muscle.  A hematoma is a collection of blood in a confined space.  If bleeding occurs in the pocket after a breast augmentation, and is not removed the accumulated blood will gradually be broken down.  As the blood is broken down inflammation occurs in the pocket which can then lead to the formation of a capsular contracture.  Any type of infection in the pocket can cause inflammation leading to a capsular contracture.  The infection can be very minor and not causing any other symptoms.

Joseph B. Eby, MD, FACS · Answer

Hello Petiteb and thanks for your question. Capsular contractures are one of the most troublesome problems associated with Breast Augmentation, fortunately the incidence is typically quoted as< 5%.  Capsular Contractures can develop for one of several known reasons such as a history of radiation, infection or hematoma. Barring any of these factors the exact etiology is unknown. Placing the implant below the muscle (smooth or textured) or above the muscle (textured) both appear to reduce the incidence of capsular contracture. As far as ways to prevent Capsules - meticulous technique and sterility reduce the risks of bleeding and infection whereas some surgeons also recommend implant massage. Capsular contractures do seem more common with older implants this may be due to the makeup of very old implants or a result of many of these rupturing and leading to thicker capsules (although no one knows which came first the rupture or the thick capsule).  A thorough discussion with a Board Certified Plastic Surgeon will give you more information and discuss this and other concerns.  Best, Dr. Joseph Eby

Arthur M. Cambeiro, MD · Answer

Capsular Contracture is one of the biggest issues after breast augmentation surgery.  The cause is unknown but there are many recommendations that surgeons follow to help decrease the risk.  Depending on the study you read the rate is of CC is round 5-10%.  It is best to discuss the matter with a board certified plastic surgeon in your area.

Milind K. Ambe, MD · Answer

One of the most common complications of breast surgery is capsular contracture.  Patients need to be educated on early signs of encapsulation because many early problems can be treated non surgically.  In addition, an experienced Plastic Surgeon who performs a lot of breast surgery should know both surgical and non surgical techniques to minimize encapsulation. Encapsulation rates should be @5% or less if all proper precautions are made.  Best of luck to you

Ronald V. DeMars, MD (Retired) · Answer

Capsular Contracture is one of the more common problems we see related to breast implants, maybe in the 5-10% range overall, but the majority of patients do not ever see the problem. We still don't have all the answers regarding it's cause, and there are no proven ways you specifically can prevent it.

How common is capsular contracture and is there a way to prevent it?

Answers (7)

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