Capsular Contracture

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Capsular Contracture

The photograph shows capsular contracture in the right breast of a 29 year old woman. The 560cc silicone gel implants are subglandular and the capsular contracture is grade IV.


What is Capsular Contracture?


As part of its immune system, the human body encapsulates any foreign object in a fibrous capsule. This will happen naturally with your breast implants. In the majority of cases, the capsule will remain soft and unnoticeable. Your breasts will look and feel natural. Unfortunately, in some cases, the capsule contracts to the extent that it becomes hard. It may cause discomfort and even pain. If this happens, your breasts may feel hard and may not have a natural shape. In some cases, the implant may need to be replaced through revision surgery. However, sometimes, a firm massage may resolve the problem.


The risk of Capsular Contracture


Capsular contracture is the most common cause of further surgery being required following breast augmentation but it is rare. Patients who smoke and those who experience complications such as an infection following breast enlargement surgery are at a higher risk of developing capsular contracture. Also patients choosing to have the sub glandular implant placement (overs) are at a higher risk.

It is reported that the introduction of breast implant shape, profile, texturetextured breast implants has served to reduce the risk of acute capsular contracture.


Severity Levels (Grades) of Capsular Contracture


Capsular contracture will always occur. It just depends as to what extent or severity. In the vast majority of cases, it does not affect the feel or appearance of the breasts. There are 4 different grades of severity of capsular contracture:

GradeDescription
I The breasts still appear natural and soft.
II The breasts are starting to feel firm, but still appear natural.
III The breasts look abnormal and feel very firm.
IV The breasts look abnormal, feel hard and are painful.

Treatment of Capsular Contracture


The extent of the capsular contracture will determine which procedure the surgeon will choose to correct the issue. There are two main treatments:

  • Closed Capsulotomy
    This involves manually squeezing the contracture from the outside in order to tear the scar envelope. This technique provides instant relief, though it is not possible with all cases of capsular contracture because the scar envelope may be more resistant to tearing in some patients. In addition, there is a risk that of breast implant rupture when using this technique, which may require going through an additional surgery in order to remove and replace the implant.

  • Open Capsulectomy
    This procedure is considered to be less risky than the closed technique. With the open capsulectomy, an incision is made in order to allow the surgeon to cut into the scar tissue and release the tension that has built up around the implant. The implant may also be reinserted before the incision is closed. In most cases, the patient will need to stay overnight in the hospital following the procedure.

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