Dr. Lisa Cassileth: Hi, I'm Dr. Lisa Cassileth. Today we're going to talk about capsular contracture. Capsular contracture is a condition that only happens with breast implants. That's the formation of scar tissue, natural body formed scar tissue, around the implant. The scar tissue forming around the breast or the capsule get's hard, thickened, and contracted. I think it's nice to remove the entire thing as a completely intact packet so there's minimal spillage of silicone and leakage of potential contents of the silicone implant into the surrounding tissue. Now, in the case that we're going to look at today, it's an en-bloc removal of both the implant. In this case, it's a silicone implant that's old, that has ruptured, and the hard scar tissue that's formed around the implant. So we're going to look at this and cut it open and see what a real capsule really is.

This is a capsule that just came out of a patient. This was removed as a complete intact block. These have been in for about 10 years and there's silicone in them. This is really like rock hard so this was really starting to hurt this patient. Now let's look in here and see what we see. See I almost can't cut through it. Can you hear the sound of this? It's like cracking an eggshell but thicker. This is a ruptured implant inside and so what's happening and what happens in everyone who has capsular contracture to some extent is this is containing the implant and this is the capsule. This is formed by the body in response to the ruptured implant in an effort to contain it.

You can see in here now, this is just regular tissue what's really in here. This is rock hard. These are called calcifications. You could see these are literally little crispy, crunchy chunks that are formed in the body as a response to the inflammation from having implants in. So as you cut these, you'll realize how hard these are. So a lot of people say that ruptured implants don't cause autoimmune disease, but certainly they cause ongoing inflammation and are source for potential sickness.

This one, when it came out of the body, was already ruptured. You can see the hole as it starts to leak out here. So this is the body's capsule that it formed in response to this leaking implant. So let's go ahead and open this up and see what it really looks like. So I'm going to . . . let's flip this open. You can see that here is the leaking implant and the body's really contained this within a shell. So this is a newer cohesive gel. You can see that the shell is kind of . . . This doesn't go anywhere. You can actually see the original mark on it, and you can see how impressively hard, the calcifications that this patient's body made in response to the implants. This is literally like it couldn't be more hard.

A lot of people ask me, "Do I need my old implant removed? Do I need my old capsule removed?" Now in a case like the one that you see now, really it's important to get all of that old capsule and scar tissue out, and it's also important to get all of the old silicone out. So if you have an old capsule, especially if you're having symptoms like hardness, pain, or God forbid, autoimmune exhaustion, symptoms like that that can be potentially related in the past to silicone leakage, it's very good to get not only the entire implant out but the entire capsule out with minimal or no leakage of the silicone whatsoever.

Hardened Breasts Could Be a Sign of a Serious Implant Malfunction

One of the most common complications from breast augmentation is capsular contracture, a condition resulting in breasts that are hard, distorted, and painful. Watch Dr. Lisa Cassileth as she dissects a removed capsule.