Is it normal to get a capsular contracture 6 months after surgery?

Question

I got my first augmentation done 6 months ago & after thinking my implants were dropping at different times I finally went in to see my surgeon & he told me I had a capsular contracture. He recommended that I have surgery to replace the implant with one that has pig skin around it. He also recommended 6-12 weeks of ultrasound therapy treatment. Will ultrasound therapy fix my contracture? Why is it that I got a capsular contracture so soon after surgery? Possibly something my surgeon did wrong?

Daniel Barrett, MD · Answer

Dear springstun,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

Zoran Potparic, MD · Answer

Based on few long term studies it seems that lifelong chance to develop breast contracture after breast augmentation with implants  is in a range of 20-40% possibly higher. In  most patients capsular contractue presents 3-4 years after augmentation; however early contracture may develop as soon as 6 weeks after breast augmentation. For the most cases a cause of contracture is unknown; usually one side (breast) is affected more than the other. If treatment with ultrasound starts early after contracture there may be a chance for improvement; surgery is next option.

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Risk factors for capsular contracture have been identified, but the exact cause of capsular contracture is unknown. The definitive treatment for capsular contracture includes (at a minimum) implant removal/exchange and total capsulectomy. If you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!Matthew A. DelMauro, M.D.

Kenneth R. Francis, MD, FACS · Answer

Dear springstun,Breast implant capsular contracture is a significantly common enough occurrence that breast implant companies offer warranty against the highest grades of the condition.  The condition has a bimodal peak, meaning that it occurs early (around 6 months), and it occurs late (after several years).  Your surgeon's approach to the correction sounds a bit extreme, but he/she has the advantage of knowing your case and having examined your contracture.  Good luck!

Jason Pozner, MD · Answer

For very early capsular contracture treatment with the Aspen ultrasound system sometimes will soften the breast. For a more advanced case my treatment (which sounds similar to what your surgeon recommended) is capsulectomy, washing with hypochlorous acid (kills all the bacteria in the pocket), implant exchange, Strattice (porcine ADM) placement, drain, and post operative Aspen sustem and antibiotics

Melinda Haws, MD, FACS · Answer

While we know some reasons capsular contracture happens, we do not know all of them. Infection and bleeding are two things but those don’t have to happen at the original surgery.  The breast is an inherently “dirty” organ in that the breast ducts are open to the outside thru your nipple. Bacteria can get in any time it wants to. Capsular contracture is one of the risks of breast augmentation and we all wish we knew a way to prevent them. I have no experience with ultrasound.  If I diagnose a cap con early enough in my own patients I can often reverse it with a medical protocol of singular/vitamin E/doxycycline. And that is often if early but not always. Keep talking with your surgeon. No one did anything wrong- this is A problem we all deal with and each of us have designed protocols to address it.

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