Can an MRI detect capsular contracture? Can an injury cause capsular contracture?

Question

My BA was done 5/2015. I have silcone under muscle. I have had zero issues until now. I had some type of trauma to my R breast about 7mo ago. It throbs, burns, tingles and my pec muscle constantly feels tight. Its aggravated w/ exercise. It hurts when I lay flat on back and its uncomfortable when i lay on right side. I had an MRI done and it basically said implants were fine.. “no fluid.. no inflammation.” Can an MRI detect capsular contracture? And can an injury cause capsular contracture? TY

William Bruno, MD · Answer

Trauma can cause capsular contracture. An MRI is not needed to diagnose it, it's a clinical diagnosis your plastic surgeon can help make. If your breast feels tight,hard and/or painful you may benefit from medical treatment (Singulair) now which could help prevent surgical treatment (implant replacement/capsulectomy). Consult with your plastic surgeon for a detailed exam.Best wishes,Dr.Bruno

Daniel Barrett, MD · Answer

Dear Deni84,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. A capsule can be detected by any experienced breast surgeon at a consultation in person. There are a number of ways Dr's detect.  I would suggest going back to the Dr who did your initial implants or to a new experienced breast surgeon. Wishing you the best of luck!Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Capsular contracture can occur in even the most careful surgeon's practice, and we do not know everything that is responsible for the occurrence of capsular contracture.  
Progression of capsular contracture is graded on a scale of I-IV: Grade I: The breast appears normal and is soft to the touch. Grade II: The implant feels disjoined and there is slight but noticeable hardening of the breast. Grade III: There is a prominent distortion in the shape of the implant, and the breast feels firm. Grade IV: There is severe pain, tenderness, and hardening in the breast, emphasized by a severe distortion in shape.
In a few cases, the affirmation of capsular contracture is accomplished through a mammogram, MRI, or ultrasound.The most important thing in this consideration is to find a plastic surgeon who does hundreds of breast augmentations and revisions who is very sophisticated in the approach to treating capsular contracture should it occur.   Best diagnosis and advice will come from an exam by a board certified PS.

Ted Eisenberg, DO, FACOS, FAACS · Answer

An in person evaluation by your surgeon, at this point, would give you a definitive answer.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and AuthorRealSelf Distinguished Hall of Fame Inductee

Douglas Taranow, DO, FACOS · Answer

Deni,Sorry you are having new issues with your breast.  Trauma can cause complications in the capsule and breast.  More commonly, there is a feeling of tightness (one side vs the other breast) when there is a capsular contracture.  The MRI can be diagnostic of a silicone implant rupture, but it cannot diagnose a capsular contracture (it might see calcium deposits in the capsular wall).  Is there any spot on the breast/axilla that accentuates the pain/discomfort when you tap it?  If so, it might be a nerve issue that can be treated with a small amount of steroid injection.Go back to your surgeon and ask for their opinion after a physical exam.Best of luck.Dr T

Rick Rosen, MD · Answer

Thank you for your question. An MRI will detect a rupture but not all the time. Trauma can cause the capsule to get tighter, and also a rupture which was why you had the MRI. I would recommend a short course of Singulair to consider, maybe ultrasound. I would recommend you discuss your options with your surgeon.

Can an MRI detect capsular contracture? Can an injury cause capsular contracture?

Answers (6)

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