African American woman concerned about post breast implants hardening and capsular contracture. What are your thoughts?
Doctor Answers 4
Hardening of the Breasts and Black Women
Dr. Peter. A. Aldea
Capsular contracture is NOT more common in African Americans
- Bacterial Infection
- Periareolar incision (natural bacteria of the breast can contaminate the implant during insertion)
- Subglandular pocket (same reason as above)
- Prolonged exposure of the implant to the surrounding surgical environment (lack of sterility in the surgical environment can cause contamination of the implant)
- Hematoma (blood can increase inflammation and speed up fibrous capsule formation)
- Use of drains (increase risk of infections by 5 folds, and thereby increase risk of CC)
- Avoiding large implants (large implants can easily be contaminated)
- Textured implants with submammary pocket (Textured implants may not help in the submuscular pocket)
- Submuscular pocket (the implant is not exposed to breast’s natural bacterial flora)
- IV antibiotics
- Washing the implant pocket with antibacterial solution
- Using insertion sleeves (i.e., Keller Funnel) for the implants (reduces contact with bacteria)
Scarring & skin Type
There are reasons to believe that Capsular Contracture can be triggered by bacteria and bleeding inside the breast pocket, but not ethnicity. African and Asian skin types do present with higher rates of keloid/dark scarring however and I recommend that my patients treat their scars with Silicone sheeting for 4-6 months post op in order to reduce their prominence.
I recommend that you speak with your Plastic Surgeon about their methods for reducing the risk of capsular contracture and scar treatment post op.
All the best