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Capsular Contracture

Occasionally a patient may experience capsular contracture after breast augmentation surgery.

Capsular contracture occurs when scar tissue that has formed around breast implants contracts or tightens, hardening around the implants. 

Although all breast augmentation patients develop capsules, or scar tissue, around their implants, about 10% of first-time breast augmentation patients experience capsular contracture.  Capsular contracture rates tend to be higher in breast reconstruction patients and for patients who have previously had treatment for capsular contracture.

Capsular contracture may develop at any time, can affect one or both breasts and is usually corrected with revision breast surgery.  Dr. Pfeifer uses meticulous surgical technique during surgery to avoid capsular contracture.  Among other details, Dr. Pfeifer does the following to reduce the incidence of capsular contracture:  the use of triple antiobiotic irrigation, covering the nipple, changing gloves before handling the implant, and minimizing contact of the implant with the patient's skin.

What does capsular contracture look like?

capsular contracture new york

Capsular contracture symptoms

Symptoms of capsular contracture are measured by the Baker Grading System, which has four stages.

Grade I describes normal capsule or scar tissue formation.  It is the ideal breast augmentation outcome because it means the capsule that forms after surgery leaves the breasts feeling soft and looking natural.

Grade II describes formation of a slightly firm capsule, however breasts still look natural.

Grade III is marked by formation of a decidedly firm capsule that distorts the shape of the breast.  It is at this stage of capsular contracture that a breast augmentation revision may be recommended, since the aesthetic outcome of breast augmentation is affected.

Grade IV is the most severe stage of capsular contracture wherein scar tissue formation leaves breasts hard and distorted, and patients experience pain and discomfort as a result.

How can you prevent capsular contracture from occurring?

Because it is impossible to anticipate exactly how your body will heal and how scar tissue will form, it is impossible to predict and prevent capsular contracture.  However, there are ways to decrease your risk for capsular contracture.

Massaging and compression exercises

Some patients are instructed to begin massaging their breasts the day after breast augmentation surgery and to perform compression exercises that involve squeezing the implant with medium pressure to keep the capsule flexible and loose in order to decrease capsular contracture risk.

Preoperative medication regimen

Prednisone, a prescription corticosteroid drug sometimes used to treat capsular contracture, and vitamin E supplements may help lower capsular contracture risk if taken for two weeks prior to breast augmentation surgery.

Breast implant placement

When breast implants are placed in a submuscular position, or under the pectoral muscles, breast augmentation patients may be less likely to develop capsular contracture than when breast implants are placed in a subglandular position, or over the pectoral muscles.

Silicone vs. saline breast implants

As compared to saline breast implants, silicone breast implants are purported to have a higher capsular contracture rate due to leaching of silicone from the implants, however data released by one breast implant company suggests that the difference in capsular contracture rates in saline vs. silicone implants is only about 1% nationwide.

Avoid smoking

Capsular contracture rates are about twice as high in smokers as in non-smokers, so avoiding smoking after breast augmentation surgery should decrease your risk for developing capsular contracture.  Most plastic surgeons will insist on smoking cessation prior to breast augmentation surgery anyway, so you may as well continue avoiding tobacco use at least until your recovery period has ended.

Other risk factors

Additionally, severe breast trauma, autoimmune disorders, radiation therapy and other breast augmentation complications, such as seroma, hematoma and infection, can also increase your risk for developing capsular contracture.

Surgical Correction of Capsular Contracture in New York City

Dr. Tracy Pfeifer specializes in the revision and correction of difficult breast cases, and has offices in Manhattan, Great Neck, and the Hamptons.

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