Capsular contracture in breast augmentation - how can you reduce the risk?

How can you reduce the risk of getting capsular contracture?

Doctor Answers 3

Reducing the risk of capsular contracture

There are several things that can be done to help.  These reduce the CC rate, but don't completely eliminate it.
1.  Place the implant behind the muscle.  Shown in multiple studies to reduce CC.
2.  Use a crease (inframammary) incision.  Shown in at least 3 recent studies to have less CC than nipple or transaxillary incisions.
3.  Wash the pocket with either betadine or an antibiotic-containing solution.
4.  Use the Keller funnel to place the implant (Shown in one study to reduce CC by 50%)
5.  Use the no-touch technique of implant placement.
6.  Consider adjunctive medications post-op (e.g. Singulair).
7.  Use meticulous hemostasis, to avoid post-op hematomas.
8.  Use techniques to reduce the infection rate - which can cause CC.

Capsular Contraction

I believe that the development of capsular contraction after breast augmentation with silicone implants is not due to anything the patient does (or does not do) following the surgery. It is known that capsule formation is a normal reaction to all implants as the body will regard them as foreign bodies. The causes for hard or excessive capsule formation are still not really understood. It is likely that there are technical and intrinsic reasons for the development of hard capsule. The type of implant used, low level bacterial contamination, excess perioperative trauma during the insertion of the implants are possible technical issues. Perhaps a genetic predisposition, maybe an intrinsic cause of abnormal capsule formation. The most important aspect, however, is to recognise them when they occur because they can be treated. So if hardening, changes in shape of the breast or discomfort develops, advice should be sought and they should be re-examined and checked.

Capsular contracture - how to reduce the risk?

Thank you for asking about your breast augmentation.
  • A good question - with no easy answer.
  • We can form capsular contractures around any implant in our body.
  • The common feature seems to be some kind of irritation of the tissues around the implant.
  • Bacteria, rough handling of tissues, handling the implant, implants over the muscle, gel implants all have a higher than average risk of causing a contracture.
  • So does sleeping in a position in which you hug an implanted breast.
  • We suspect that chronic infections (sinusitis, bacberial vaginosis, infected teeth.) increase the risk of CC.
  • But often we don't know the reason -
  • We do know the risk of a CC is 5% every year that you have the implant.
  • We do know that if a severe CC forms, removing the implant and capsule entirely, placing acellular dermal material over a new, smaller implant in a new position is the best surgery we have to solve the problem. . 

Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

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.