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Capsular Contracture of Breast Implant Treatment Review

Published by Dr. Brandon Richland, MD

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Understanding Capsular Contracture

Capsular contracture is a condition that can occur after breast implant surgery, affecting the softness and shape of the breast. It involves the body’s response to the foreign object and can lead to various complications if not managed properly.

Definitions and Causes

Capsular Contracture: It is a complication that arises when the scar tissue (or capsule) that normally forms around a breast implant tightens and becomes firmer than usual. This process can squeeze the implant, causing various degrees of firmness, pain, and aesthetic distortion.

The causes of capsular contracture are thought to include:

  • Bacterial Contamination: Even a minute amount of bacteria can lead to an immune response resulting in scar tissue overgrowth.
  • Hematoma and Seroma: Collections of blood (hematoma) or fluid (seroma) around the implant can pave the way for inflammation and subsequent contracture.
  • Genetic predisposition: Some individuals might be genetically more prone to develop this condition.
  • Immune Response: The body’s immune system can overreact to the presence of the implant, contributing to excessive scar tissue formation.

Risk Factors

Risk factors associated with capsular contracture include:

  • Infection: Postoperative infections can significantly increase the risk.
  • Previous experience of capsular contracture.
  • Surgical technique and implant placement: Placement above the muscle (subglandular) may have a higher incidence than under the muscle (submuscular).

Understanding these aspects can aid in both the prevention and management of capsular contracture, potentially reducing its impact on patients with breast implants.

Treatment and Management

When addressing capsular contracture, patients and healthcare providers must consider a variety of treatment and management strategies. The chosen method depends on the severity of the contracture, overall health of the patient, and specific goals for recovery.

Evaluating Treatment Options

Capsular contracture is graded from I to IV, with grade I being the most mild and grade IV being the most severe. Treatment options vary from massage and medication for early stages to surgical intervention for more advanced cases. Patients are advised to carefully consider each treatment’s potential benefits and risks.

Surgical Approaches

For higher grades of capsular contracture, surgical measures such as capsulectomy or capsulotomy may be necessary.

  • Capsulectomy: Complete removal of the scar tissue capsule.
  • Capsulotomy: The surgical release of the capsule; it can be open or closed.
  • Open Capsulotomy: Involves making an incision to access the capsule directly.
  • Closed Capsulotomy: Historically entailed manually breaking the capsule by compressing the breast but is rarely performed today due to the risk of implant rupture.

Nonsurgical Methods

In certain cases, nonsurgical options may help manage mild forms of capsular contracture. These may include:

  • Medications: Such as anti-inflammatories or specific drugs which may help reduce the formation of scar tissue or alleviate symptoms.
  • Ultrasound: Can assist in reducing inflammation and encouraging tissue relaxation.
  • Massage: Some surgeons recommend breast massage techniques to keep the breast pocket open and the implant moving freely, possibly reducing the risk of contracture.

Prevention and Aftercare

When considering breast implants, understanding how to prevent complications and manage aftercare is crucial for a positive breast augmentation recovery. The prevention of capsular contracture involves careful surgical planning and meticulous postoperative care.

Surgical Planning

Choosing the Right Surgeon: Patients should ensure they are working with a board-certified plastic surgeon. This ensures that the surgeon has the highest levels of training and adheres to rigorous safety standards.

Implant Placement: The surgeon may consider the placement of the implant either above (subglandular) or below (submuscular) the pectoral muscle. Submuscular placement has been associated with a reduced risk of capsular contracture.

  • Subglandular Placement: Above the pectoral muscle but below the breast tissue.
  • Submuscular Placement: Beneath the pectoral muscle, which may result in a more natural contour and lower risk of contracture.

Surgical Technique: Surgeons may employ various surgical techniques aimed at reducing the risk of capsular contracture. This includes minimizing the handling of implants, using a no-touch technique, and ensuring the implant pocket is disinfected.

Postoperative Care

Recovery Guidance: Following surgery, adherence to the surgeon’s recovery plan is essential. This often includes wearing a support garment and following specific movement restrictions to allow for proper healing of the implant pocket.

Avoiding Risk Factors:

  • Smoking: Patients are advised to avoid smoking before and after surgery as it can impair healing and increase the risk of complications.
  • Post-surgical Massage: Some surgeons recommend breast massage to help keep the tissue around the implant flexible.

By closely following a surgeon’s instructions for surgical planning and postoperative care, patients can help minimize the risk of capsular contracture and support a smoother recovery process.

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Contact Dr. Richland today by visiting RichlandMD.com, scheduling a cosmetic consultation, or by calling 714-844-0398 or 949-997-2958 directly.

Cover Image Illustration by: Dr. Brandon Richland, MD