Effective Treatment of Capsular Contracture
#Capsular #Contracture is a condition in which the capsule around the implant
thickens and squeezes the implant making it hard and often changing the shape
and position of the implant. It is more common in nicotine users (e.g. smoking
or nicotine patches or gum). Effective treatment of the capsule frequently
involves completely removal of the capsule (capsulectomy), and occasional
incisions in the capsule may be somewhat helpful (#capsulotomy). In the past,
closed capsulotomy, in which the breast is squeezed until the #capsule breaks,
was used. Currently, most doctors avoid this technique because of complications
associated with the technique and because the implant companies will void their
warranty if this technique is used. At times it is necessary to change the position
of the implant, either above or below the muscle, depending upon the initial
position, changing the #implants themselves and, on occasion, the use of
Acellular Dermal Matrix (ADM) may be required to prevent continued problems.
Although the published risk of capsular contracture is approximately 9-11%, in
our practice it is somewhat lower after initial implant placement. Once
capsular contracture occurs, the risk of problems with secondary surgery rises
to between 25% and 40%. The use of #Singulair and Vitamin E may be of benefit.
If you had a Sientra Textured Implant placed as a primary procedure and a
contracture occurs in the first two years after primary augmentation, then
their implant warranty may apply.
When contractures occur
your options are limited. You can simply leave things as they are until it reaches a point where you have to have something done. You could explore Aspen ultrasound technology but before I plunk down dollars for this, I would ask for some kind of warranty... from partial refunds or free sessions if it doesn't improve after you've had the recommended number of treatments. Finally, you could return to the OR for a more definitive repair and scraping the pocket out is not one of them. Terms such a neopocket, new implant, ADM, Keller Funnel, antibiotic irrigation of pocket are terms that should be reviewed during your consultation.
Treatment options for capsular contracture
Unfortunately the options for nonsurgical treatment of capsular contracture are limited. There is no evidence that massage helps. Medications such as Accolate work sometimes but are rarely completely effective. Ultrasound is being studied and there a franchises that offer it but they have not yet reported results despite having done it for several years, so that is a red flag. The most effective option is implant replacement, capsulectomy, and use of an ADM such as Strattice.