What Are the Chances That Capsular Contracture Will Occur Again and Can I Do Anything to Help Prevent It?

In April of 2002 I had a breast lift and augmentation. In August of 2002 had surgery to correct the capsular contraction that had occured in my left breast. I'm a bit fuzzy on some of the details but the surgeon decided to remove both of the implants and after a few months of healing put them back in. I decided not to have them put back in since they didn't look that bad. Now after 2 pregnancies and breastfeeding 3 kids I have lost fullness. Since time has passed does that make a difference?

Doctor Answers 14

Preventing a recurrent capsular contracture

If you have a previous capsular contractures then the odds of another problem area very high.  You may want to consider the use of an interposition graft using Strattise.  This has been shown clinically to reduce the risk of recurrence.  I would not place too much emphasis on Singular or Vitamin E.


Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Preventing another capsular contracture

You are probably at lower risk for another capsular contracture given that the implants were removed and you have had time to heal. Go with the common denominators in the advice you see on these posts: Under muscle, no-touch technique (this is facilitated by using what is called a Keller funnel), antibiotic irrigation. Massage is of unproven benefit, as is vitamin E, and the use of Singulair might help in some cases but the evidence is highly variable.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Preventing capsular contracture with breast implants

You may be at a slightly higher risk of developing capsular contracture (hard scar tissue) since you have already had it once in the past. I would recommend having your new implants placed under your pectoral muscle (subpectoral). Studies show that some saline implants have a slightly lower incidence of capsular contracture also. Early massage, high doses of Vitamin E (taken orally) and Singulair (an asthma medication) have all shown to help minimize the risk of capsular contracture.

You can also speak with a board certified plastic surgeon about having a piece of Acellular Dermal Matrix, which is a synthetic skin (derived from pig or human) which can be sewn into the breast pocket and reduce the chances of capsular contracture.

Capsular contracture occurs in about 10% of all patients that have breast implants, so consult with a few plastic surgeons before you make your decision as this can be very difficult to treat and prevent.

Best wishes,

Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 reviews

Minimizing capsular contracture

Minimizing capsular contracture requires both intraoperative maneuvers and postoperative maneuvers.

Operative Measures

1. Minimum touch technique

2. Irrigation with antibiotics

3. Meticulous hemostasis

4. Placement of implant under the muscle

Postoperative Maneuvers

1. Capsular contracture prophylaxis exercises

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Recurrent Capsular Contracture-Science vs Myths

It appears that if you ask 3 plastic surgeons about recurrent capsular contracture, you are going to get three different answer, however:

  • Most of the scientific data on capsular contracture point to bacteria and trauma as the causes of capsular contracture
  • The research on implant texture is inconclusive, but to date the only conclusion is that there may be a possible benefit from textured implants in the subglandular position
  • revisional surgery for capsular contracture should include the complete removal of the old capsule whenever possible, washing out the pocket with an antibiotic solution, and replacement with new implants
  • In your case it might be a good idea to try to find a physician who has lower revision capsular contracture rates and understands the steps that they can take to help reduce recurrent capsule formation...it does NOT have to be 50%
  • If your first doctor completely removed your old capsule, your recurrent capsule rate should be about the same as a first time augmentation, provided the doctor can do a bloodless augmentation and uses antibiotic irrigation. 

Caroline Glicksman, MD
Sea Girt Plastic Surgeon
4.6 out of 5 stars 10 reviews

What Are the Chances That Capsular Contracture Will Occur Again and Can I Do Anything to Help Prevent It?

If you have not had implants since 2002, your tissues have healed and your risks are not much higher than someone who has not had implants.  Some studies show that behind the muscle has a slightly lower risk of encapsulation, but not conclusive.  I would strongly recommend using a Board Certified Plastic Surgeon who uses a "no touch technique" as this has been shown to reduce your risks.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 106 reviews

Capsular contracture recurrence

Since you no longer have implants and want them back in, I would suggest to have them placed in a different pocket plane.  You still have a risk or a new capsule but withotu an exam  and knowing exactly how you were treated last time, it is hard to say.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

With capsular contracture time can make all the difference

The figures often quoted for capsular contracture after breast implants is from 2 - 9% and are similar for both silicone gel and saline breast implants. Most capsules will occur within the first two years and often on one side. These 'early' capsules can be very hard to resolve and even after surgery to release them the recurrence is as high as 50%. Removing implants and replacing them after several years can change everything, especially if the implants are place under the muscle. Your risk of recurrence should drift toward the 2-9% range, the exact risk we can't know.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Recurrent Capsular Contracture

Capsular contracture does have a high rate of recurrence, but your situation is a little unusual.  Most patients have their implants replaced when the contracture is treated operatively.  The best chance of preventing recurrence is to move the implants to a different location.  I would still suggect that in your case as well, even though several years have past.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Preventing Capsular Contracture

One of the most common problems is breast #capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule #contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer implant. 

Nicotine users, such as smokers, have up to a 30 times increased #risk of capsular contracture. The #reason capsular contraction happen is unclear. It's possibly caused by microscopic bacteria on the implant, a   collection of blood after surgery or perhaps it is a tendency for some women to form scar tissue. What we do know is that is cases reported have decreased from 25% to  5-10% or less. 

Capsular contracture may recur regardless of surgeries being performed at this time and may require additional surgeries. There is as much as a 40% chance that additional surgery will be needed following this operation. One way to attempt the prevention of it is to follow your surgeon's post op instructions as recommended and ask questions of your surgeon when healing concerns arise.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 107 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.