How to reduce the risk of capsular contracture?

I am having my breast augmentation done in a month and I am a little worried about the possibility of capsular contracture happening... I was wondering if there is anything I can do to limit the chance of this happening? Any tips or advice would be greatly appreciated!

Doctor Answers 5

How to reduce the risk of capsule contracture?

The art of avoiding capsular contracture after breast augmentation is nebulous and unclear.  We each have different preferences based on our experience so I will explain to you mine.
I encourage all of my patients to avoid blood thinners leading up to and for at least one month after surgery.  I commence massage exercises in the hope that preventing and resisting tightening of the pocket will reduce the incidence of capsule contracture but it is debatable whether this is truly of benefit.  I personally believe it is rather important to have my patients avoid physical use of their upper extremities since all of my implants are placed in a subpectoral position and there is a risk of bleeding from tearing of the muscle before it has healed at six weeks after surgery.  Consequently, I encourage my patients to avoid lifting, pushing or pulling anything that would require force greater than that required to lift a pillow or towel for the first two weeks. For weeks three through six I ask my patients to avoid forceful use of greater than 2 to 5 pounds.  It is the incidental and unexpected use of the arms that can lead to problems such as when opening a refrigerator door, grabbing a locked car door or pushing out of a chair as one gets up.  Planning for this in advance is helpful and I think beneficial.Intraoperatively I have been using a funnel for implant insertion and diluted antiseptic solution to bathe the pocket in a further effort to reduce the incidence of capsule contracture.
The odds are in your favor of achieving a nice soft and natural result so do not over worry.  I am sure you are in good hands with a board-certified plastic surgeon performing your procedure.
Best wishes,
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Reducing the risk of capsular contracture

Thank you for your question.This is a good question and unfortunately one that we can not answer with good scientific data.  There is some weak evidence to suggest that the use of a insertion device can decrease capsular contracture.  Various implant soaking or rinsing solutions have been described and again there is weak evidence for their use.  Some surgeons swear by post operative massage, for round implants. I wouldn't massage shaped or anatomic device for fear of malposition.  There is also some weak evidence for singulair, ultrasound, vitamin E among other things. There is also some weak evidence on where the implant is placed or whether it is textured or smooth.  I would suggest addressing your concerns with your surgeon and candidly ask what strategies they use to minimize capsular contracture.From your standpoint what you can do to decrease the risk is to follow all your surgeon's pre and post operative instructions.Best Dr. L

Andre Levesque, MD
Austin Plastic Surgeon
5.0 out of 5 stars 1 review

No Nicotine!

Hi heatherkeith, Because surgeons don’t know the precise cause of capsular contracture, there is no one method of preventing it from happening. Some doctors suspect that the type of implant is a major factor, while others think that bleeding during and after surgery and/or subclinical bacterial infection are major causes of contractures. There is a great deal of ongoing research attempting to discover the exact cause, but based on what we know now, here are some things that will reduce your risk: Choose submuscular implant placement. More and more evidence show that sub-muscular placement of the implant does better than Subglandular placement in the long term, but even this has not been scientifically proven; Choose the right size. Oversized implants may lead to capsular contracture; Take a good rest after surgery. Engaging in too much activity during the first few weeks after surgery increases your risk of bleeding. Minimal or profuse bleeding likely increases your risk of contracture; Choose a qualified surgeon who works at an accredited facility. A surgeon who specializes in breast augmentation surgery, and who works in a highly accredited hospital with strict infection control policies assuring more safety to the patients and decreases the risk of capsular contracture; Avoid smoking. Capsular contracture rates are twice as high in smokers!! Good luck and don't worry too much.

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 35 reviews

Minimizing capsular contracure

The risk of capsular contracture 10 years from the time of your procedure is 15- 30%. Certain factors slightly increase or decrease the risk. Typically, implants placed below the muscle have a slightly lower incidence of capsular contracture. Implant massaging after surgery can potentially minimize this as well. Smoking has been shown to increase the risk of capsular contracture. Therefore, instructions from your plastic surgeon on implant massaging and cessation of smoking if you do smoke are some things that you have control over. The decision of placing the implant above or below the muscle depends upon a combination of your measurements, tissue characteristics and a mutual discussion with your plastic surgeon. Allergan, Mentor and Sientra all have industry standard warranties on silicone implants for capsular contracture to help assist financially for any revisionary surgery that may be required to address this issue. I am not exactly sure of which implant manufacturers are available in Great Britain. You should discuss these concerns with your plastic surgeon.Best wishes,Dr. Ravi Somayazula

Ravi Somayazula, DO
Sugar Land Plastic Surgeon
4.8 out of 5 stars 53 reviews

Capsular Contracture

Thank you for your question.  It is important for you to consult with your surgeon about any questions or concerns you may have seeing as they know your medical history, anatomy and surgery best and every surgeon has slightly different post-operative protocols. Regular breast massage and taking Vitamin E supplements can help prevent a capsular contracture from occurring and your surgeon may prescribe you Singulair if you do develop one. I hope this helps.
Best of luck in your recovery!

Sincerely,

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 68 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.