Percentage/Stats about Capsular Contracture?

Can anyone give me more updated, newer stats with percentage of having Capsular Contracture. Which implants are prone to having CC? I have tried looking up online but so many have not updated the stats as they all are from year 2011.

Doctor Answers 10

Breasts augmentation

Dear Lea,

    I understand your concerned, however, breasts augmentation is one of the best investment that you can make in yourself. It will increase your self esteem, your confidence, your sense of femininity and will make shopping great fun... 

   Breasts augmentation with implants is the number one cosmetic surgery in the US, for a good reason. Yes, complications do occur, but at a very low rate. There is risk in every good thing, though it is worth taking if the risk/reward ratio is dramatically in favor of the reward !

    You main concern, in my opinion, should concentrate on selecting your right surgeon, because not all results are the same. Experience, skills and aesthetic eye are critical for good outcome. So, do your due diligence carefully and select your surgeon wisely to avoid bad result and need for corrective surgery.

     Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety . Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural look. Also, check the reviews on 'RealSelf' for ratings and for positive experience reports.

                          Best of luck,

                                                Dr Widder

Rate of Capsular Contracture

Thank you for your important question!

Capsular contracture refers to tightening of the scar tissue that normally forms around the implants resulting in hardened, painful, and abnormal looking breasts with varying degrees of severity. The capsule is fibrous tissue that NATURALLY forms when anything foreign is placed in our body – this happens with heart devices as well. However, when there is too much inflammation, fluid collection, or bacterial contamination, the fibrous capsule can start to scar down further and contract.

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.

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.

Often other studies will only consider Grade 3-4 as capsular contracture as they actually require surgery (i.e., tearing of the capsule, or complete removal of the capsule and the implant). However, some will include 2 as well causing the rate of capsular contracture to be higher. So let’s first understand that this is one reason for the variability in the rates. The risk of capsular contracture can depend on many things like incision site, pocket location, implant and surgical skills. From anecdotal evidence of many surgeons, the rate of occurrence can range from 1-2%.

Older studies (i.e., before year 2000) report capsular contracture to occur in up to 59% of patients, and its recurrence after correction surgery can be from 18.1-39.7%. More recent studies hint that capsular contracture rates range from 1-2% for breast augmentations through the inframammary incision and the transaxillary incision, although it is higher (1-9%) for surgeries through the periareolar incision.


Nevertheless, I don’t think you should be concerned over the rates of capsular contracture from studies, because it clearly varies depending on the surgeon performing the procedure. So it would be better to ask your surgeon about the incidence of capsular contracture when they perform breast augmentations.


That being said, a literature review by Dr. Chong & Dr. Deva titled Understanding the Etiology and Prevention of Capsular Contracture (CC), clearly outlines what can increase and decrease the chances of capsular contracture and all things are ultimately related to implant contamination.

 

Initiators:

  • 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)

Suppressors:

  • Avoiding large implants (large implants can easily be contaminated)
  • Avoiding use of drains
  • Avoiding manipulation of the implant and excessive exposure to open air
  • Textured implants with subglandular pocket (Textured implants may not help in the submuscular pocket)
  • Submuscular pocket (the implant is not exposed to breast’s natural bacterial flora)
  • IV and oral antibiotic prophylaxis during and after surgery
  • Washing the implant pocket and the implant with antibacterial solution
  • Using insertion sleeves (i.e., Keller Funnel) for the implants (reduces contact with bacteria)
  • Using nipple shields to prevent implant contamination from nipple discharge
  • Achieving blood-less dissection using electrocautery

If these risk factors are considered and incorporated into the surgical planning by your surgeon, the risk of capsular contracture dramatically drops.

I hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 reviews

Capsular contracture

Capsular contracture is a major concern with breast augmentation.  Many people feel it is a result of small numbers of bacteria that aren't enough to cause infection but cause inflammation around the implant that causes more scar to be put down around the implant.  This usually occurs in the first year after augmentation.  In my practice there are 10 things I do in the Operating Rooms to prevent capsular contratcture including using the Keller Funnel.  These things keep my rates below 1%.  Ask your surgeon how they try to minimize this problem.  

William Koenig, MD
Rochester Plastic Surgeon
4.8 out of 5 stars 54 reviews

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Capsular contracture

Hello and thank you for the question. Capsular contracture is one of the most frequent complications with breast augmentation surgery. it is not life threatening, but does create a difficult and sometimes painful condition for the patient. It can be difficult to correct and may require treatment, medication, and additional surgery. 

The best option is prevention. Historical data shows capsular contracture ( CC ) to be 10% up to 45% depending on the study. Generally, the best risk strategy:

1. under the muscle 

2. avoid the nipple incision

3. careful surgical dissection with minimal bleeding ( hematoma / bleeding leads to increase risk of CC ) 

4. Textured have a lower risk of CC than smooth ( but this is a small difference and only noted in a few studies ) 

There is newer evidence that points to a biofilm as the main culprit. It is theorized that the milk ducts which are open, contain these bacteria and when the nipple incision is used, some of the these bacteria will "seed" land on the implant and lead to a biofilm on the implant. This can also occur from the skin incision, so careful sterile technique is a must for implants. 

Hope this answers your questions. The reality is that CC has a very low risk today, and with some careful measures, the risk can be minimized as much as possible. 

Best to you. 


Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 16 reviews

Capsular contracture

Most studies average out at 3-5% in the first 5-10 years but this increase to 8-10% thereafter  so overall not so common - there are various methods used to reduce capsule likelihood and you should ask your surgeon how they approach prevention

Capsular contracture

The rate using modern techniques is about 3-5% according to the data.  However, older studies show the rate higher at 10-15%.  Placing the implant under the muscle and not using the areolar incision reduces the chance of capsular contracture. 

Tyler C. Street, MD
Napa Plastic Surgeon

#breastaugmentation #implants #plasticsurgery

Hello learoni, thank you for your excellent question. I highly recommend scheduling a consultation with a board certified Plastic Surgeon to discuss your options and formulate a surgical plan that is tailored specifically to your health and needs. When setting up an in-person consult with a plastic surgeon look for someone who has at least one of these credentials: *Board Certified by the American Board of Plastic Surgery - the gold star symbol  *A member of the ASPS (American Society of Plastic Surgeons) - the circle symbol  *A member of the ASAPS (American Society of Aesthetic Plastic Surgeons) - the Queen Nefertiti symbol with a Triangle.   Feel free to contact our office, it would be our pleasure to answer your questions in person. My very best to you, Brian S. Coan, MD, FACS   CARE Plastic Surgery

Brian Coan, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 52 reviews

Risk of Capsular Contracture

Thank you very much for your question. Capsular contracture, or extensive scar tissue forming around the breast implant, is a concern with breast augmentation. Research shows that between 4-5% of women will have capsular contracture sometime during the first three years after their breast augmentation. However, the condition may occur at any time. For this reason, I recommend that you see a board certified plastic surgeon for your breast augmentation procedure. If unusual pain, swelling, firmness, or a distortion in shape should occur in one or both breasts at any time, contact your operating surgeon right away, so the condition can be diagnosed and addressed appropriately. 

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 104 reviews

Capsular contracture rates

The implants used today all have similar risks. The risk of a capsular contracture in the first 3 years is between 3-5% and increases a bit more over time.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast implant capsular contracture rate.

Thanks for this question. Saline implants under the muscle have a contracture rate between 1-4 % each year. As i tell my patients the number is low, but not 0. Silicone implants historically had a higher rate of contracture increased with gel bleed or rupture. The new generation of implants on the market in the U.S. have a sturdier shell and more " cohesive silicone. The use of a keller funnel may be less traumatic in placing the implant, but this remains to be proven.These new implants have been out for widespread use for only about 10 years so the contracture rate is still being looked at. 


Hope this helps.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 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.