Is there a relationship between body mass and CC?

Hi, I am 46 year old postmenopausal woman, 5 feet 9 inches and 130 lbs. I exercise every day and I feel good and healthy. After a consultation for breast augmentation the surgeon told me that I am underweight and should gain weight to avoid risk for Capsular Contracture (CC). I don't want to gain weight.

Doctor Answers 8

Body mass isn’t a risk factor for capsular contracture.

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Capsular contracture occurs when excessive scar tissue builds up around your implants, becoming rigid and even painful. There are no known links between low body weight and the likelihood for capsular contracture. Some of the most common causes of capsular contracture include a leaking or ruptured implants, hematoma and the presence of bacteria in the breast implant pocket. I suggest getting a second opinion from a board-certified plastic surgeon to discuss your candidacy for a breast augmentation.  

Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 77 reviews

Understand capsular contracture in breast implants

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Thank you for your question.

I have never found an association between body mass and capsular contracture. Basing your decisions on evidence-based research is highly important. If I were you, I would ask your surgeon what he/she is basing this recommendation on.

The literature review by Dr. Chong & Dr. Deva titled Understanding the Etiology and Prevention of Capsular Contracture, clearly outlines what can increase and decrease the chances of capsular contracture and all things are ultimately related to implant contamination and not body mass.

Risk Factors:
  1. Bacterial Infection
  2. Periareolar incision (natural bacteria of the breast can contaminate the implant during insertion)
  3. Subglandular pocket (same reason as above)
  4. Prolonged exposure of the implant to the surrounding surgical environment (lack of sterility in the surgical environment can cause contamination of the implant)
  5. Hematoma (blood can increase inflammation and speed up fibrous capsule formation)
  6. Use of drains (increase risk of infections by 5 folds, and thereby increase risk of CC)

Preventative measures:
  1. Avoiding large implants (large implants can easily be contaminated)
  2. Textured implants with submammary pocket (Textured implants may not help in the submuscular pocket)
  3. Submuscular pocket (the implant is not exposed to breast’s natural bacterial flora)
  4. IV antibiotics
  5. Washing the implant pocket with antibacterial solution
  6. Using insertion sleeves (i.e., Keller Funnel) for the implants (reduces contact with bacteria)
These are the only things research has shown to influence the risk of capsular contracture.
Don’t hesitate to seek a 2nd opinion.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 reviews

Body Weight and Capsular Contracture

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To the best of my knowledge and experience, there is no correlation between body weight and the development of capsular contracture. 
It is true, however, that if you put a large implant in a small breast, it will feel firmer or look and feel less natural than if you put a smaller implant in a larger breast.  This is a function of how much tissue is covering the implant and should not be confused with capsular contracture.
Instead of gaining weight, consider a second opinion with another board certified plastic surgeon.

Martin B. Weiss, MD
Boston Plastic Surgeon

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BMI and CC

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Dear Aneri,
  Congratulation on perfect BMI - 19. 
 I have been in plastic surgery practice for 29 years. I have never heard, read or noticed personally any association between BMI and capsule contracture. 
 The most common causes for capsule contracture are bleeding, infection or biofilm (bacteria embeded in the capsule and on the implant).
 It sounds like you need to have an additional consultation with an experienced, skilled and knowledgeable board certified plastic surgeon who operates in accredited surgery center for your safety.
  Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.
              Best of luck and stay skinny,
                                                             Dr Widder

Capsular contracture and BMI

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I do not know of any studies suggesting that capsular contracture is associated with a higher BMI. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Capsular Contracture and Body Weight

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While I am not aware of firm data on this subject, in my experience under weight patients tend to a higher risk of capsular contracture and have less coverage to cover the implant if the contracture is a lower grade like grade one or two.

You don't have to gain weight but you are likely to get a less appealing result if you are under weight for your height.

Regardless of your weight or body mass index, a good diet with lean protein, complex carbs (fruits and veggies) and non-animal based fat is a good idea for best healing.

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews

Body mass and capsular contracture

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I don't believe there is any relationship between body mass and capsular contracture. It is sometimes helpful to get a second opinion. I recommend a board-certified plastic surgeon who has an excellent reputation, good preoperative and postoperative photos, and who is especially experienced in this field.

Ira H. Rex lll, MD
Fall River Plastic Surgeon
4.7 out of 5 stars 51 reviews

Is there a relationship between body mass and CC?

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If the implants are placed under the muscle there should be an excellent chance that capsular contracture can be avoided even in a very thin patient.  It is true, however, that the edges of the implant (or rippling when it occurs) tend to be more visible on some very thin patients. 

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.