What can I do to reduce the risk of capsular contracture appearing?

I'm having breast augmentation in 3 months. Can I do anything prior and after the surgery to minimize the risk of capsular contracture. Thank you for your responses.

Doctor Answers 13

Reducing capsular contracture

Hello, capsular contracture could be due to low-grade breast implant contamination, bleeding around the implant, or other factors.  Some of these factors can be mitigated by the surgeon during surgery.  If you choose an experienced, board-certified PS who stays up to date with their surgical techniques, they are likely going to take many steps to try to decrease the risk of CC.

Toronto Plastic Surgeon
5.0 out of 5 stars 63 reviews

Capsular Contracture Prevention

Thank you for your question. One thing that you can do before your surgery is to chose the right plastic surgeon. It is important that your surgeon is board certified by American Board of Plastic Surgery. You can inquire about steps your doctor takes during and after surgery to decrease the chances of capsular contraction. For instance, I recommend an inframammary incision for breast augmentation since studies show this method decreases capsule formation. I take additional precautions during surgery and use special surgical techniques that further lower complications. After surgery, I encourage patients to massage implants. For patients developing a problem with early encapsulation, I will prescribe Accolate, which has been used by plastic surgeons as an off- label medication to combat capsular contraction. Hope that helps. Good luck!

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 114 reviews

Reducing capsular contracture

What works:
  • use of Keller funnel for implant insertion
  • antibiotic irrigation of pocket prior to implant insertion
  • inframammary fold incision
  • under muscle placement
What might help:
  • textured implants
  • leukotriene inhibitors (such as Singulair)
What doesn't help:
  • implant massage

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Minimizing the risks for contractures

starts with your surgeon's techniques and some are simply more compulsive than others.  Find out from your surgeon what he/she intends to do to help minimize contractures for you and compare with published literature you can find on-line to see if you will be meeting most if not all of the recommendations.  This includes antibiotic irrigation of the pocket, use of a Keller funnel with gel implants, nipple shield, pre-op antibiotics, etc.  And some surgeons are just cleaner than others... scrub techs know and can tell you if you have access to them.   And if you're unfortunate enough to experience a post-op hematoma, it needs to be evacuated and removed and not left in you to reabsorb on its own.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Capsular Contracture Prevention


Thank you for your question. In my practice I use a "no touch" technique and a bloodless breast augmentation technique in order top help prevent contamination and bleeding into the breast pocket during surgery. You can ensure that every precaution is taken during surgery by choosing an experienced, board certified Plastic Surgeon and talk with them about their approach. As well I advise my patients to take precautions against bleeding during and after surgery. I do not recommend massage of the implants within the first 10 days or so in order to reduce the risk of bleeding/hematoma. It will be up to you to follow your Plastic Surgeon's instructions about activity and medication restrictions. Follow up regularly to ensure  you are on track as you heal.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

What can I do to reduce the risk of capsular contracture appearing?

I believe strongly that a regimen combining limited exertion with your upper extremities, massage (possibly helpful) and good surgical technique will give you the best chances of avoiding capsular contracture.  Watch the video below for more information and good luck!

Jon A Perlman MD FACS
Certified, Am Bd of Plastic Surgery
Member, Am. Society of Aesthetic Plastic Surgeons (ASAPS)
Beverly Hills, CA

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Prevention of Capsular contracture

Dear Ms. Maggie123,

Thank you for your questions.

Prevention of capsular I believe has three parts:
1) sub muscular placement
2) use of textured implant (has other limitations)
3) access incision: inframammary (breast crease)
4) intra operative contamination:
A) changing non powdered gloves prior to insertion (use of Keller funnel)
B) physical skin barriers (op site over breast and incision site)
C) minimal touching of implant
5) intraoperative irrigation of breast pocket with a antibiotic solution
6) pre and post surgical antibiotics
7) gentle handling of tissue
8) precise hemostasis (no blood left behind)

1) Antibacterial scrub of breasts night before and morning of surgery
2) avoidance of any smoking (first or second hand)
3) regular displacement exercises of breast implants
4) limited antibiotic coverage for future  major dental procedures  or surgery.
5) avoidance of medications that can lead to bleeding after surgery
(Aspirin, Motrin, Alleve , etc)

1) certain individuals can do all of the above a still acquire a capsular contracture.
2) certain individuals can skip all of the above a not acquire a capsular contracture.

I recommend that you make several consultative appointments with Plastic Surgeons who are experienced and Certified by the American Board of Plastic Surgery. In addition ideally they are members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

I wish you my best and success,
R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Robert A. Hardesty, MD, FACS
Riverside Plastic Surgeon
4.8 out of 5 stars 98 reviews

Minimizing risk of capsular contracture

Early onset capsular contracture is secondary to
1)subclinical or clinical infection
2)bleeding into the breast pockets
3)contaminants (such as powder or lint on your surgeons glove)

Although you cannot do anything about #3, you can definitely reduce your risks for # 1 and #2. These measures include:
a)avoiding any sick individuals, avoiding smoking,large groups of people, or any activities that would increase risk of getting an infection such as soar throat, bronchitis, urinary track infection, ear infection, etc. If you get an infection anywhere, the bacteria can get into the bloodstream and find your newly placed implant. 
b)avoid anything that will make your blood thin placing you at increased risk of bleeding in the operating room. You should get the comprehensive list of medications, supplements, and food groups that you should avoid from your surgeon.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Capsular contracture

Thanks for your very good question. Capsular contracture remains somewhat of an elusive phenomenon, and we still don't have an exact cause for it (although there are several theories). Most women with breast implants do very well for many years. You just want to be in the best shape and health that you can be prior to surgery, and then maintain a healthy lifestyle afterward. You will then follow up routinely w/ your surgeon to track the progress. Best wishes.

Paul J. Leahy, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 8 reviews

Reduce Risks of Capsular Contracture

Most of the science in the reduction of "Capsular Contracture" is more related to what the surgeon does intraoperatively as well as the choice of implant types and location of placement either above or below the muscle. On the patient's side, I believe that the avoidance of cigarette smoking does diminish the risk of capsular contracture. Ask your chosen plastic surgeon for his or her thoughts on this topic. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.