Ultrasound or Laser Treatment for Capsular Contracture?

Question

So I had a B/A done almost 6 months ago and at 3 months developed capsular contracture on left breast. I have been on accolate for 2 months and now just recently my right side is starting the same thing. Is there such a thing as laser treatment for helping capsular contracture? I read there was this treatment for capsular contracture with ultrasound through a facility called Aspen Rehabilation?

Richard Baxter, MD · Answer

Sorry to hear about your experience. Capsular contracture remains a difficult problem. I haven't heard of any laser treatments for it, but there are a few reports that ultrasound can be helpful. It may also help to take antibiotics while the treatments are being done. The idea is that the ultrasound disrupts the scar allowing the antibiotics to penetrate. We have tried this a couple of times and while we have had some success it doesn't always work.
best

Michael S. Beckenstein, MD · Answer

To date there are no true and tested ways to prevent or relax the capsular contracture. Contrary to what you hear it is not scar tissue! The capsule is it's own, 4 layer entitiy that has the ability to contract. Early and daily massage can help the process, but there are no proven methods to treat this.

Shahram Salemy, MD, FACS · Answer

I don't know of any good data that supports ultrasound as an option for capsular contracture that could provide consistent results. If the accolate does not work, then you will most likely require surgery in the form of a capsulotomy (removal of the capsules) and replacement of the implants.

Steven H. Williams, MD · Answer

Thanks for the question -
Capsular contracture is a known complication of breast augmentation.  Bilateral capsular contracture this close to your breast augmentation while you're on Accolate is unusual.
It is likely that you will need replacement of your implants with capsulectomy.  Other treatments may not be adequate.  Ultrasound has produced some disappointing results for capsular contracture resolution.
Be sure to discuss your situation with your plastic surgeon as soon as possible.
I hope this helps.

Otto Joseph Placik, MD · Answer

There are a variety of modalities that have been claimed to be beneficial for the management of capsular contracture but few have proven to be effective.
Ultrasound may be helpful but its effects on the integrity of the implant itself are unknown and one could surmise that it may decrease the longevity of the implant.
I am not aware of any laser treatment that has been of any value in the treatment of capsular contracture.
It is my educated guess that surgery is your best option.
Consider sub muscular smooth saline implants as an option if you have not had this performed.

Christopher L. Hess, MD · Answer

Capsular contracture is the most concerning complication following breast augmentation yet one of the rarest.  Capsular contracture occurs when the capsule around the implant becomes hardened.  Why this happens we don't know.  What we do know is that there are things that increase its risk and things that can reduce its occurrence.  What is most important for your information is that capsular contracture is a long term complication that does not show up for several years, not several months.  So that fact that your breasts are getting firm already is a little concerning.
If it's true capsular contracture then only surgery will help.  The implants must be placed under the muscle.  The capsular contracture rate between silicone and saline implants when placed under the muscle is essentially the same.  Don't go for closed capsulotomy or any other "voodoo" procedure.

John P. Di Saia, MD · Answer

Hello,
The only "tried and true" treatment for defined capsular contracture is removal of the capsule, but you seem to be having the problem very early. Make sure your surgeon is following you through this, so other contributing factors like infection and bleeding can be excluded.
If you try one of these newer (I consider them experimental) treatments just don't rely upon it working. Did your surgeon recommend these treatments to you? I just wouldn't want you spending a lot of money on garbage.

Scott E. Kasden, MD, FACS · Answer

If you read the information correctly, it is total B.S. Neither laser nor ultrasound will help a capsular contracture. It is unfortunate that you are suffering presently however the acolate may work, and ibuprophen may also work too.

Bahram Ghaderi, MD · Answer

Capsular contracture remains a difficult problem to treat. Techniques have changed over the decades to decrease its incidence but there is still no perfect preventative measure or treatment to avoid recurrence. Accolate has been reported to be helpful but it is considered off-label use and has some adverse side effects that should be reviewed and considered before using it. Surgery is another option but that also has risks. There have been no reports of lasers being used and ultrasound has not been proven. If you have low grade capsular contracture, then lower level treatments are the answer. If you have high grade contracture, then you may want to discuss surgical options with your surgeon.

David A. Dreyfuss, MD · Answer

As much as all Plastic Surgeons would like an easy cutaneous method to reduce or remove a contracture, they don't exist. Any ads for these things are gimmicks and will only release money from your wallet, not release your contracture.
You need to discuss surgical options with your doctor. The implants may need to be changed for a textured implant. You may need a complete capsulotomy/capsulectomy.  You may need to have the implant placed in a different pocket. A qualified Plastic Surgeon should be able to discuss these options with you. Keep massaging on a daily basis to help prevent further progression. I have been disappointed with the Accolate, but other doctors swear it helps.
Good Luck!

Ultrasound or Laser Treatment for Capsular Contracture?

Answers (11)

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