Breast replacement 1 year post-explant - any success stopping the capsular?

Dear Diligent954426 thank you for your question.
Capsular contracture occurs when scar tissue hardens around one or both implants. Although this is seen in around 10% of patients, the risk increases when implants are in place for over 10 or 15 years. Breast implants are not lifetime devices, so if you are planning on getting a new breast augmentation you should bear in mind that you might need another surgery in a few years to remove or exchange the implants.

Hello, thank you for your question. Unfortunately once you have had capsular contracture you have a higher likelihood of this happening again. Usually we wash out the pocket very well, going under the muscle reduces the chances of capsular contracture and we typically place our patients on medication to help prevent that. Speak to your plastic surgeon about your medical options and risks.

Dear Diligent954426,
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

Yes. If any of the old capsule can be removed it’s worth removing. If the original implants were above the muscle, go below the muscle this time. And use saline instead of silicone. They have a much lower incidence of capsule.

Based on your description, it sounds as though you have had multiple episodes of capsular contracture in the past. That by itself would put you at increased risk for developing another problematic capsule. The standard treatment of capsular contracture includes removing the capsule, placing the implants under the muscle, and using new implants, which I assume your surgeon had done previously. While nothing is guaranteed, the use of acellular dermal matrix around the implant has been shown to decrease the rate of capsular contracture. The addition of acellular dermal matrix is expensive and would be expected to significantly increase the cost of surgery. You could also try taking leukotriene inhibitors (montelukast and zafirlukast). These are antiallergy medications with little side effects but have good evidence in reducing the risk of capsular contracture.

The old leaking gel implants had a much higher rate of capsule formation than the newer nonleaking gel implants. Giving yourself a good year should also be helpful in decreasing your risk. The lowest risk is still with saline implants. I would also suggest considering something smaller in size.

Unfortunately if you have had capsular contracture in the past you are at a higher risk of developing it in the future. However there are techniques that we use to minimize this risk. Some include using the Keller Funnel during surgery, placing implants beneath the muscle, and bathing the pocket and implants with antibacterial solution prior to augmentation. I encourage you to discuss your concerns with your surgeon to learn more. I've included a video on capsular contracture that I hope you find helpful.

Hi and welcome to our forum!
Following the procedure of saline or silicone augmentation mammoplasty, the surgical wounds seal and undergo the healing process. This occurs in the underlying soft tissues as well. The silicone polymer making up the shell of the breast implant is biologically inert, and as such, the body creates a thin filmy internal scar which surrounds the implant, holding it in its position. Thus, all breast implant procedures involve the development of a thin capsule. This becomes problematic only if the scar shrinks substantially around the implant, thus causing a capsular contracture. Manufacturer publications state that this will occur in approximately 10% of all augmentation procedures.
Generally, capsular contracture only needs to be addressed if the patient experiences discomfort or if the implant becomes displaced, affecting the aesthetic outcome.
The precise cause of capsular contracture is unknown but is unique amongst individuals and their individual immune response to the placement of a foreign body. Its incidence is increased in the presence of infection. Capsular contracture is not predictable nor a by-product of surgical quality. It is highly recommended patients learn and follow a massage routine that will dramatically reduce the incidence of contracture. While postoperative massage will help prevent contracture, there exists the possibility that the degree of contracture may require an outpatient procedure to remove the scar tissue.
In your situation, re-augmentation is indeed a possibility, but the same factors which created the initial capsule may lead to recurrence. By placing the new implants in a different plane (over / under muscle), the incidence of recurrence may be reduced.
Best wishes...