What is the current statistic for capsular contracture in breast implant patients?

Question

I am planning to get breast augmentation and the most concerned about capsular contracture. I understand that encapsulation is normal for foreign objects introduced in the body. What is the current statistic for capsular contracture in breast implant patients? And in Australia what is the protocol to minimize such problem? Thank you.

Stefan Mark Szczerba, MD · Answer

Any experience plastic surgeon will tell you that capsular contracture is quite rare.  I do over 300 implant cases per year and my personal experience is 5 patients in 18 years- however each of the those 5 patients failed to follow instructions on how to avoid this rare issue.  There are very good internal solutions that we use to sterilize the pocket and start patients on implant massage at 1 week.  Do your homework and seek out an experienced plastic surgeon!  Best Wishes!!

Ted Eisenberg, DO, FACOS, FAACS · Answer

The U. S. FDA Breast Implant Post-approval study evaluated long-term outcomes of 99,933 patients. The Baker III and Baker IV capsular contracture reported rates for smooth devices used for primary breast augmentation were as follows: Allergan’s silicone gel rate was 5% at 2 years; while its saline rate was 2.8% at 2 years. In this study, Mentor reported no saline data.
Mentor reports its Memory Silicone Gel capsular contracture rate at 12% at 10 years. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Zoran Potparic, MD · Answer

Capsule (scar) around foreign body (breast and any other implant) is normal, inflammatory reaction of our body to a foreign material; every patient who received breast implant will develop capsule around it. However, 1 out of 4 patients with breast implants (based on available statistics) will develop clinically visible/palpable contracture deformity in the span of a few weeks to 40 years after implant placement. Hope this helps.

Daniel Barrett, MD · Answer

Dear gainmyselfback,
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Capsular contracture is a risk with breast augmentation.  However there are many steps that can be taken to minimize the risk of this occurring.  In my practice I often use the Keller funnel to place silicone implants.  This minimizes touching the implant.  I also bathe the breast pocket with antibiotic solution. Placing the implant beneath the muscle and using an inframammary incision helps to lower the capsular contracture rate.  I've included a video on this topic that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

The risks of capsule formation that is bothersome in saline implants is around 5% and 5-10% with gel implants. To avoid hard capsule formation, get a dose of antibiotics prior to dental procedures, and get on antibiotics quickly for any bacterial infections, including sinus infections, to avoid the infection spreading to the implants. Late infections are often the cause of capsule formation once healed. If you notice one of your breast becoming hard, please go back to your surgeon for treatment with Accolate and possible external ultrasound treatments.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
Following the procedure of saline or silicone augmentation mammoplasty, the surgical wounds seal and undergo the healing process. This occurs in the underlying soft tissues as well. The silicone polymer making up the shell of the breast implant is biologically inert, and as such, the body creates a thin filmy internal scar which surrounds the implant, holding it in its position. Thus, all breast implant procedures involve the development of a thin capsule.  This becomes problematic only if the scar shrinks substantially around the implant, thus causing a capsular contracture. This phenomenon will occur in approximately 10%-15% of all breast augmentation procedures.
Generally, capsular contracture only needs to be addressed if the patient experiences discomfort or if the implant becomes displaced, affecting the aesthetic outcome.

Some surgeons administer oral or IV antibiotics as a preventative measure. Some surgeons employ intraoperative irrigation of the surgical wound with antibiotic solution prior to wound closure. Some surgeons will use "no touch" technique where the implants are placed into sterile plastic sheathing and are introduced into the breast pockets without human contact. Some surgeons recommend massage of the breasts after surgery to lessen the risk of contracture. Some surgeons use drains to prevent postoperative fluid collection within the pocket. Implant placement beneath the pectoralis muscle reduces the incidence of capsular contracture. Some surgeons advocate administration of perioperative steroids.
Trust your plastic surgeon's judgement (based upon training and years of clinical experience) as to what is required to achieve the best result.
Best wishes...

What is the current statistic for capsular contracture in breast implant patients?

Answers (7)

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