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Capsular contracture after breast augmentation is dependent more on other factors than silicone vs. saline. Since the newest generation of silicone gel implants are cohesive and cannot leak (and also have very minimal molecular "bleed" through the shell into the surrounding tissues), they act very similar to saline implants, which have the exact same silicone elastomer shell in contact with your tissues. Theoretically, capsular contracture should be exactly equal (assuming all other factors--surgical technique, healing, and genetics of patients--are also exactly equal) with either type of implant. The problem is that these latter factors are MUCH MORE variable than the innate tendency for implants of either type to stimulate excessive scar capsule contracture. Overall, our capsular contracture rate is around 1.5-3% with implants of either type, and plastic surgeons who utilize careful precise technique with good hemostasis, and patients who follow recommendations that minimize bleeding or bruising, enjoy similarly low capsular contracture rates. Surgeons who do blunt dissection, have significant bleeding and post-op bruising in their patients, use drains, leave implants out on the back table before putting them into your body, place implants behind the breast rather than behind the muscle (less intraductal bacteria exposure behind the muscle), or don't use powderless gloves, antibiotic (specific to breast bacteria) or Betadine irrigation, or minimal- to no-touch technique WILL have a higher capsular contracture rate, since all of these factors play a role in scar formation around implants. Much more so than implant fill material! So, the message here is that it is much more important to choose a plastic surgeon who follows good capsular contracture-avoidance surgical techniques (see the list above) rather than worry about choosing saline vs. silicone to avoid CC. All things being otherwise equal, you will probably be most happy with silicone implants, as 98-99% of my patients choose these over saline, and many of my previous saline implant patients (and all of my nurses who had saline implants) have switched to silicone implants. Many also go slightly larger, so that is also a bit of unasked-for advice--go on the "high-side" of what you want to be. That gives you the highest chance of having a happy result, and no capsular contracture! Best wishes!
Despite all the experience plastic surgeons have had over the years, capsular contracture is still poorly understood as far as its cause, how to avoid it, and how to treat it with predictable success. You will get many different answers to your question depending on whom you ask. The overall incidence is probably less than 10 percent, and most of the time it is just a matter of bad luck as opposed to anything the surgeon either did or did not do. If you elect to undergo breast augmentation, you just need to realize that it is a small risk of the procedure regardless of technique or the surgeon you go to.
The rate of capsular contracture with silicone implants is about 10%. It is believed that this rate is even slightly lower if your incision is placed under the breast (in the breast crease) compared to an areolar incision. Having the implant placed behind or under the pectoral muscle has a lower rate than above the muscle. Consult with a board certified plastic surgeon for more specific details regarding capsular contracture. Best wishes, Dr.Bruno
You will find different answers depending on where you look. Implant companies usually quote up to 25% (you can check the mentor or allergan websites). Some doctors quote under 5 % , I think 9-11% is more accurate. Some patients will be a little firm.. At the extreme , just a few are hard, and painful.
Both silicone and saline implants have the same shell so the risk should be equivalent. The shell is what confers the risk of capsular contracture. That being said, even in 2011 we don't exactly know what causes some patients to develop capsules. One of the few things we do know is that hematomas increase the risk for capsules so please alert your surgeon if one breast is significantly more painful or swollen after surgery.
