Capsular contracture - how quick can you usually tell if this is going to happen or not?
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Capsular contracture - how quick can you usually tell if this is going to happen or not
Concerns over capsular contracture 2 days postop
In general, capsular contracture (CC) can occur at any time, but most cases are documented in under 12 months (i.e., anywhere from 3 months to 12 months post operation). This is because it takes time for the fibrous tissue capsule to form around the implant, and then it will have to scar down (contract).
Nevertheless, CC can start early when there is significant bleeding or infection or another co-existing problem.
Now regarding your concerns, because you had 310 cc ultra high profile over the muscle, the breasts will feel firm and tight which is common with capsular contracture. However, such tightness is just because the breast tissue and skin have not adopted to the implants yet. With effects of gravity and healing, the breasts will feel more natural and soft as time goes.
Now I need you to know that there are 4 grades/levels of capsular contracture:
- Grade I — the breast is normally soft and appears natural in size and shape.
- Grade II — the breast is a little firm, but appears normal.
- Grade III — the breast is firm and appears abnormal.
- Grade IV — the breast is hard, painful to the touch, and appears abnormal.
If your breasts do not appear abnormal, tight, firm, or painful, then you are fine and shouldn’t not be concerned, especially because it has only been 2 days.
Now, grades 1 and 2 CC do not require surgery, and can be fixed with breast massaging and singulair.
Massaging will keep the naturally occurring capsule stretched hindering it from contracting. However, this should not be done excessively as you may further aggravate the breast pocket causing inflammation.
If all these treatments fail, then surgical correction is your next option. There are two methods for surgical correction: removing the capsule (capsulectomy) and releasing/tearing the capsule (capsulotomy).
In terms of what can and cannot cause capsular contracture, we can refer to a recent literature review by Dr. Chong & Dr. Deva titled Understanding the Etiology and Prevention of Capsular Contracture. This clearly outlines what can increase and decrease the chances of capsular contracture and all things are ultimately related to implant contamination.
- 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)
That being said, you can also help prevent a capsular contracture by having regular follow-ups with your surgeon to make sure your breasts are healing beautifully.
Hope this helps