This 46 year-old-patient from Pacific Palisades, CA had severe capsular contracture and ruptured implants that…
One of the most common complications from breast augmentation is capsular contracture or capsular contraction, a condition that results in distorted and sometimes even painful, hard breasts. Read on to learn more about the signs of capsular contracture, your treatment options, and Cassileth Plastic Surgery’s innovative technique to handle capsular contracture in Beverly Hills.
Capsular contracture is a hardening, tightening, and thickening of the natural tissue surrounding a breast implant, which causes the breast to become distorted or feel painful and hard.
Capsular Contracture Before & Afters
Capsular Contracture Details
A capsule is the normal tissue that the body produces to surround a breast implant. It is usually pretty thin—and sometimes almost transparent. The capsule is larger than the implant itself, allowing them both to move around and feel soft.
In capsular contracture, the capsule becomes thicker and tightens, which makes the space for the implant smaller and smaller. The capsule can get so small that the implant feels firm (Grade III) or can even feel hard and be painful (Grade IV).
Grades of Capsular Contracture
- Grade I — the breast is normally soft and appears natural in size and shape
- Grade II — the breast is a little firm, but appears normal
- Grade III — the breast is firm and appears abnormal
- Grade IV — the breast is hard, painful to the touch, and appears abnormal
Studies show that up to 26.9 percent of women who receive breast implant surgery will develop capsular contracture.
What to watch for
Signs of capsular contracture are the implant moving to a higher position on the chest, the breast tightening and becoming round like a baseball, or the implant feeling firm and/or painful. Traditional methods of capsular contracture repair often result in recurrence, but our surgeons have created a technique with a success rate of more than 95 percent.
Preventing Capsular Contracture from reoccurring
Cassileth Plastic Surgery has created a plan to help prevent recurrence of capsular contracture: We remove the infected implant and capsule, use an acellular dermal matrix to prevent recapsulization from occurring, and treat the infection. During this breast surgery, our doctors take a small sample (also called a biopsy) of the capsule, which is sent to a lab to test for bacteria and fungus.
Removal of the implant and capsule
During capsular contracture surgery, our doctors carefully remove the complete capsule, including any fluid around the implant, granulation or inflammatory tissue within the capsule, or free-floating silicone that can sometimes leak from a ruptured implant. Next, our doctors use an antibiotic power wash to combat potential sources of inflammation that may be responsible for causing contracture. Finally, an anti-bacterial solution is left within the breast to complete the sterilization process.
Creating the internal bra
Once the implant and capsule have been removed, our doctors create an internal bra with acellular dermal matrix (ADM), a biomaterial that resists contracture and provides a protective layer between the breast and the implant. The ADM allows the body’s natural reaction to occur so a healthy capsule can form and fuse with the ADM, keeping the pocket soft and pliable. It also supports the implants and keeps your breasts in the ideal shape and position.
After your procedure, you will be kept on antibiotics until test results come back. If bacteria growth is present, we will send you for a consult with an infectious disease specialist. You will begin a course of antibiotics tailored to the results of your microbiology tests. If your results are negative (no infection), you will undergo a shorter course of prophylactic antibiotics.
Capsular Contracture treatment results
Our doctors insist that all patients undergo a six-month scar treatment regimen after surgery to minimize all scars. During the healing period, the breasts often have tight or small lumpy areas where the internal sutures are located. This is common and is most prominent four to eight weeks after surgery. These sutures are absorbable, and any lumps caused by them will resolve.
Your breasts need up to six months to fully heal and take their final shape. Our team will discuss with you what kind of support and activity you will need during this time.