Does exercising too soon after surgery cause capsular contracture?

Question

I teach classes at the gym. Of course I'm going to take time off to heal, but I'm worried about developing capsular contracture when returning to my workouts. Does working out too soon contribute to capsular contracture?

Larry S. Nichter, MD, MS, FACS · Answer

You should talk to your doctor as only he/she knows your medical history and your treatment plan. Although capsular contractures following breast augmentation can occur just about any time, most women start having symptoms around three months after their breast implant surgery. This is because it takes some time for a capsule to form and then to scar down (contracture).Capsular Contracture is a condition in which the capsule surrounding the implant thickens and contracts, squeezing the implant making it overly firm or hard and often changing the shape and position of the implant. As the capsule contracts it moves the implant further up your chest wall making upper portion of your breast too large and unshapely. It is more far more common in nicotine users (e.g. smoking, vaping or nicotine gum or patches).

Ronald J. Edelson, MD · Answer

No is really sure what causes capsular contracture.  Exercise probably is not a factor, but you should clear resumption of exercise with your surgeon.

Stephen Bresnick, MD · Answer

Capsular contracture, or firming of the breasts is known to be associated with several risk factors.  One of these is accumulation of bloody fluid around your breast implants.  This can be caused by early trauma following surgery, such as pectoral exercises, running, falling, etc.  It is important to let you breasts heal for a few weeks before working out.  Please check with your doctor to review their recommendations.

Malcolm A. Lesavoy, MD, FACS · Answer

Exercise does not contribute to capsular contraction.  Don't worry about it, and after healing has progressed (3-4 weeks), go for it.Malcolm Lesavoy, MD

John J. Edney, MD · Answer

Working out by itself should not cause a capsular contracture.  If return to work out however is too early and causes some degree of internal bleeding a capsular contracture could develop.  The cause of capsule contracture is poorly understood.  It appears however that the common feature preceding capsular contracture is some type of inflammatory process.  This may include an infection in the pocket or a collection of blood that is not removed.  Blood remaining in the pocket creates an inflammatory response as it is broken down.  Return to exercise too early could lead to this type of bleeding and cause a capsular contracture.  After you are well healed working out should not increase your risk for a capsule contracture. It will be very important to closely follow the postoperative recommendations of your surgeon.  Good luck

Anthony Youn, MD · Answer

There is no evidence to suggest that early exercise causes capsular contracture. The only way this might occur is if you get back to working out way too early and develop postop bleeding. This can predispose to the condition.Make sure to follow your surgeon's instructions and good luck!

Gary L. Ross, MBChB, FRCS · Answer

There are certain exercises to stay clear of in the first 6 weeks and your PS will be able to advise. At the end of the day every PS has different instructions and recommendations and it is important to stick with these. There is no evidence regarding exercise being linked to capsular contracture.

Remus Repta, MD · Answer

Thank you for the question.  Although we don't have a complete understanding of capsule contracture cause, most of the current thinking revolves around the presence of prolonged inflammation.  The source of this can be bacteria or an event like a hematoma.  With that said, unless you actually develop a hematoma while working out, I do not think that activity itself would increase your chance of getting a breast implant capsule contracture.All the best,Dr. Remus Repta

Baruch Jacobs, MD, FACS · Answer

Actually, we believe that moving your arms and contracting your muscles may reduce the incidence of capsular contracture. Speak with your plastic surgeon as to what postop restrictions he would like you to follow.

Scott L. Replogle, MD (retired) · Answer

The simple answer to your question is no. Capsule contracture seems to be caused by something that irritates the capsule and causes it to react by contracting. Although it is not known for sure and may be different in different cases, the leading cause seems to be low grade bacteria. This is one reason to avoid exposure to skin bacteria such as happens in a periareolar incision approach. The key to breast augmentation success is to get a properly sized breast implant properly positioned and then to get it to heal there without problems. I recommend two weeks of uneventful healing before stressing upper body muscles and start gradually but this has nothing to do with capsule contracture

Does exercising too soon after surgery cause capsular contracture?

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