Chances of capsular contracture with anatomical implants?

I wanted to know if the odds are in my favor if I were to change my mind and get textured anatomical breast implants instead of smooth round implants? Doing flash recovery and using a Keller funnel. I've tried to research it but all the articles are a couple years old that I've found.

Doctor Answers 7

Capsular Contracture Risks with Anatomic Implants?

There are a number of strategies that can be used to minimize the risk of capsular contracture. The most important factors would be to place the implant under the muscle or dual plane position, and the second is to place the implant through an inframammary or under the fold incision. There are variable results from different studies, but it is not clear that there is a substantial reduction in the risk of capsular contracture between textured versus smooth implants when the implant is placed under the muscle.

It makes sense that using a Keller funnel would reduce the risk of capsular contracture because it minimizes handling of the implant, but I am not aware of any studies that confirm this is true. Other processes employed by your surgeon such as careful, bloodless dissection of the implant pocket, irrigation of the pocket with triple antibiotic solution, and minimizing handling of the implant will also reduce the risk of capsular contracture. If your surgeon uses all of these techniques, then your risk of capsular contracture should be extremely low, but it is not possible to eliminate this risk entirely.

Capsular contracture

The short answer to your question is yes, an anatomic textured implant tends to have a lower rate of contracture than smooth round does.  The Mentor anatomic implant has a very low contracture rate, as well as a lower rupture rate than other implants.  For women who are trying to maximize their odds, these are the implants that I use.  That said, the majority of the implants I use in my practice are smooth round gel implants, as I feel they give the most natural appearing results.

Anatomical Implants

Hello,

Anatomical implants necessitate surgical behavior that decreases the risk of capsular contracture: tissue based implant selection and an inframammary incision.  In addition, the use of all electrocautery dissection, triple antibiotic/half strength Betadine solution saline irrigation, funnel delivery, and minimizing or eliminating the use of sizers all decreases capsular contracture risk. There is no reason for surgeons not to have a 1% to 2% rate of cc using these techniques, regardless of implant type.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Chances of capsular contracture with anatomical implants?

There are no definitive recent studies on the rates of capsular contracture versus smooth silicone implants.  Most of the data originates from an earlier generation of implants that are quite different than today's modern anatomic implants.  FDA approval data for textured anatomic implants would suggest that the capsular contracture rate might be a little less than smooth round implants in the submuscular plane.  Risk of capsular contracture should be extremely low using an inframammary fold approach, antimicrobial irrigation, and a no-touch technique (e.g. Keller Funnel).  

Michael Brucker, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 24 reviews

Risks for contractures

are lower with textured shaped implants but the numbers are all single digit so yes they are better but not by leaps and bounds to make them the implant choice 100% of the time.  All products have pros and cons and my preferences for my patients are smooth round under the muscle and textured anatomic on top of the muscle with the Keller Funnel... but a flash recovery?  Yes, they write about it but I never try to sell it as what my patients will experience as most do not 'flash recover'.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

How to decrease your chances for capsular contracture

Hello and thank you for your question. There are many strategies shown to help decrease the occurrence of capsular contracture. There are factors that YOU control and others that YOUR SURGEON controls. Here is the breakdown:

FACTORS THAT YOU (THE PATIENT) CONTROL:
1) not using any nicotine products at all
2) choosing a board certified plastic surgeon
3) not having any procedures done within 6 months after your surgery that can seed bacteria to your implants (like dental work and other procedures)
4) Not having your nipples pierced

FACTORS THAT YOUR SURGEON CONTROLS:
1) Inframammary crease incision to insert implants
2) Using a Keller funnel to insert your implants
3) Using a consistent operating room team
4) Performing surgery at a hospital or highly credentialed surgery center
5) Using triple antibiotics to irrigate your implants and also the breast pocket
6) Placing implants in the submuscular pocket
7) Placing nipple shields to decrease chances for bacterial contamination during your surgery

There is some evidence that textured breast implants may have a SLIGHT advantage in decreasing capsular contracture versus smooth implants, but this advantage is not medically significant when the implants are placed under the muscle or in a dual plane pocket.  I think the most important thing for you is to decide if you like the round look more or the shaped look.  If you like the way shaped implants look more, then what you get is a no-brainer. If you like the round implants more, you can get EITHER smooth or textured.  In my very lean patients, I like using smooth round implants as they are slightly less palpable. Otherwise, I make the decision on a case by case determination. If you are unsure about what has been recommended to you, go get a second opinion and try on implants that fit your frame that are shaped versus round based on your base width and other measurements.  Make sure to seek consultation with a board certified plastic surgeon with expertise in aesthetic breast surgery.

I hope this helps and good luck!

Sincerely,

Dr. Sean Kelishadi

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 22 reviews

Chances of capsular contracture with anatomical implants?

Shaped implants are all textured. There is a small statistical reduction in the rate of capsular contracture when textured implants are uses as opposed to smooth implants. The rate is relatively small for both types when under the muscle and the risk still exists for any implant type.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 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.