What is the percentage rate of getting capsular contracture with silicone implants?

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.

I think the lifetime risk of developing a capsular contracture is somewher in the neighborhood of 5-10%.

The risk of capsular contracture depends on a few things. It is much higher in breast reconstruction than breast augmentation. Patients who had it once, seem more likely to develop in again.

Based on the large studies by Mentor and Allergan (the 2 main implant manufacturers in the USA), the rates of Baker Grade 3 or 4 capsular contracture for primary breast augmentation are:

Allergan 16% at 7 years

Mentor 8% at 3 years

Silicone Implants are much different today than they were years ago...but much of the data we use is still based on our older experience.  Capsule contracture rates for silicone implants depends on many factors including the techniques and precautions used when placing the implants.  It will also depend on issues during your early post-op period.  If all patients were considered the overall rate is about 5% depending on how the study was done.  However, these rates are a bit higher when implants are placed over the muscle rather than under the muscle.  This is why silicone implants are generally placed under the muscle.  I do believe, however, that there are situations when placing implants over the muscle has some advantages- even though the capsule contracture rate is higher.  Other factors such as infection or bleeding may also increase the risk.

Overall the capsular contracture rates for silicone gel breast implants is from 2 to 8%. There are different grades of contracture, and variablilty of reporting, even in published data. The risk of capsular contracture is low for most practices, though for silicone gel the capsule rates increase over long periods of time because of implant leak and silicone bleed.

Best of luck, peterejohnsonmd.com

There are several studies on the subject and the incidence appears to be somewhere between 5 and 8%. More importantly, the capsular contracture rate can be very surgeon dependent. Sloppy surgeons will have a higher rate due to blood product around the implant. Get more than one opinion from experienced breast surgeons. Good luck!