How Long Does It Take Capsular Contracture to Occur?

Question

I just had a 2nd capsulotomy on my right breast. A drain was placed this time. I am only 4 days out but so far so good except for some moderate pain at incision site. What are the odds this will occur again and are there any meds I could take or things to do to help prevent another capsule?

Steven H. Williams, MD · Answer

Thanks for the question -
Unfortunately capsular contracture can happen at any time.  There is a progressive risk as time goes on.  In patients that have had capsular contracture I feel replacing the implant at time of capsulectomy can be an effective way at minimizing recurrence.
There have been reports that a leukotriene inhibitor called Accolate may help prevent capsular contracture but the FDA has not looked at this indication and usage for capsular contracture is considered off-label.
I hope this helps.

Steven Wallach, MD · Answer

A capsular contracture can really happen at any time. Unfortunately if you have had one in the past, your odds of getting one again is definitely higher than the general breast implant population.

John P. Di Saia, MD · Answer

Hello,
If you have silicone-gel implants, contracture can happen over the longer term unless you develop infection or smoke or have radiation treatment (such as for breast cancer) which all make contracture more likely. Unfortunately, recurrence after having surgical treatment for contracture is more likely than in first time implant patients.
In general, the longer you go without significant contracture, the better your odds for not developing it.

Peter E. Johnson, MD · Answer

The exact cause of capsular contracture, or firmness and rounding up of the breast implant after augmentation is not clearly understood. The incidence can be affected by the type of implant used, and the location of the pocket. We know the saline implant has a lower capsule contracture rate than the silicone gel implant, and that submuscular placement has a much lower capsular contracture rate than a subglandular implant. Over long periods of time such as several years, again the saline implant stays softer while the rate of capsular contracture for the silicone gel  implant continues to rise.
When contracture does occur it is often seen within two to three months, often on one side only. We generally see contracture develop within the first two years and if not patients will not develop the problem except after many years in the case of the silicone gel implant.
The contracture rates for the saline  implant is about 2%, and for the silicone gel implant 10%. The number will vary depending on the particular sudy, or perhaps on a particular surgeon's experience.
Once a patient develops a contracture massage may be beneficial, though open capsulotomy or cutting the capsule may be needed.  The recurrence rate after cutting the capsule is 50%. Yes one out of two! Other options to consider may be replacement of a gel  implant with a saline one, or placing a subglandular implant into a submuscular position. There are no effective medication to treat contracture at this time which has been shown safe and effective.
Massage, and be hopeful, and best of luck,
peterejohnsonmd

Brooke R. Seckel, MD, FACS (retired) · Answer

Because of your previous capsular contracture after breast implants you risk of a recurrant capsule is about 50% compared to 10-13 % for first time breast augmentation.
Breast massage or displacement exercises are very important as they stretch the normal capsule that forms and can keep the implant moving freely in the pocket.
Ibuprofen has smooth muscle relaxant properties and can be used during the first few weeks and may help, anecdotally.

How Long Does It Take Capsular Contracture to Occur?

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