Whats The Chance of Capsular Contracture Happening Twice?

Dear valerie marie,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.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

One of the most common problems is breast #capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule #contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer implant. 
Nicotine users, such as smokers, have up to a 30 times increased #risk of capsular contracture. The #reason capsular contraction happen is unclear. It's possibly caused by microscopic bacteria on the implant, a   collection of blood after surgery or perhaps it is a tendency for some women to form scar tissue. What we do know is that is cases reported have decreased from 25% to  5-10% or less. 
Capsular contracture may recur regardless of surgeries being performed at this time and may require additional surgeries. There is as much as a 40% chance that additional surgery will be needed following this operation. One way to attempt the prevention of it is to follow your surgeon's post op instructions as recommended and ask questions of your surgeon when healing concerns arise.

    Capsular contracture has been reported at varying rates following breast augmentation.  5% may be a fair number, but the chances after one occurrence is higher.  Kenneth Hughes, MD Los Angeles, CA

Dear Valerie Marie, although there are some predisposing factors independent from the implant such as haematoma or dormant infection, the chances for you to develop a contracture are exactly the same as after the first operation.

The only implants which have a significantly lower CC rate are the ones with a coating of polyurethane foam. I know that unfortunately these are not available anymore in the USA, although they were used extensively in the nineties. 

We offer these implants to all of our patients for almost 15 years now, and are very happy with the outcome.

Your question is very complicated.  Capsular contracture is not always preventable.  It can occur due to an infection, radiation, hematoma or just the way and individual heals.  Capsular contracture can be minimized from the surgeon's side by placing the implant underneath the muscle. This may be a prudent way to go given that placing the implant above the muscle is known to have a higher rate of capsular contracture. Some surgeons advocate breast massage as away to keep an implant mobile in a capsular pocket. Its effects on capsular contracture are debatable and unknown. Truly because of the complexity, you should consult with a board certified plastic surgeon who is comfortable with complicated revisions of the breast.

A hematoma that is not drained definitely puts you at an increased risk of a recurrent capsular contracture.  If it was drained then  you should not have a problem.  

Given that your initial breast implant encapsulation was secondary to a hematoma,  it is quite likely that you will not develop this problem again. Generally speaking, however patients who have had breast implant encapsulation ( especially not related to a specific complication such as hematoma) are at higher risk for developing recurrence of the encapsulation. The use of massage/displacement exercises, anti-inflammatory medications, and even ultrasound therapy may be helpful in prevention of recurrence.  See which one of these modalities, if any, your plastic surgeon recommends.

 Best wishes.

Since you had a capsular contracture occur once you are at increased risk of another developing.  With that in mind do all the things your surgeon tells you such as massage.  We do know and I have seen it happen that hematoma contributes to capsular contracture.  One other thing you can do which is supported by evidence.  That is Singulair.  It is an asthma drug that has been shown to decrease capsular contracture.  Ask your surgeon if he could write a prescription for you.  Also smokers are at higher risk.

A patient with a history of capsular contracture is likelier to get another as complared with a patient who has never had one. 

All the best.