BreastImplantCCBlogWhat is capsular contracture?

Capsular contracture is the abnormal hardening of scar tissue around any medical device placed within the body. In the field of Plastic Surgery, this condition can occur in the tissues surrounding one or both breast implants. This hardening causes breast tissue distortion, tightening, discomfort or even pain.

There are four grades of capsular contracture, known as Baker Grades. The grades are as follows.

Grade I – Breast is soft and appears natural

Grade II – Breast is a slightly firm, but appears normal

Grade III – Breast is firm and appears distorted

Grade IV – Breast is hard and appears distorted

Why does capsular contracture occur?

There are several factors that may contribute to the development of capsular contracture. These include hematoma, i.e. bleeding, or leakage of the silicone gel from a ruptured implant. Hematomas or implant ruptures can potentially occur in patients at anytime. Patients may have experienced trauma from an especially rough mammogram or from impact due to a fall or car accident. Bleeding, in particular, around the implant right after surgery or after trauma can be a stimulating factor that causes thickening of the breast implant capsule. Studies also show that bacterial contamination contributes significantly to the formation of abnormal capsule formation acutely or chronically. Bacteriae form a biofilm or slime layer around a breast implant which may cause inflammation within the capsule. This results in hardening, discomfort, and change in breast shape.

How is capsular contracture treated?

Grade III and IV capsular contractures are severe and generally require removal of the breast implant and excision of scar tissue (capsulectomy) surrounding the implant. If revision augmentation is desired, it is important to use a new breast implant. Surgery can be performed in one stage. But, in some cases it may be necessary to perform surgery in 2 stages with removal of the implant(s) and capsule(s) at stage one, and revision breast augmentation with placement of new implants at stage two. Unfortunately, once capsular contracture develops in a patient, the chance of recurrence in that same patient is much higher compared to a patient who has never developed the condition. Sometimes, a more expensive option is required which involves placement of acellular dermal matrixes or ADMs, such as Alloderm or Strattice, between the new implant and the patient’s breast tissue.

How to prevent capsular contracture?

There are a number of things that can reduce the risk of capsular contracture. These include:

1. Textured implants

2. Antibiotics

3. Submuscular placement of the implant

4. Inframammary incisions

5. Minimizing the handling of the implant during surgery

If you have feel that you have developed capsular contracture and are interested learning about the best options for treatment, call us at (760) 655-1414 or contact us online to schedule your comprehensive consultation. More information about revision breast augmentation surgery is available at www.drgregpark.com/breast-procedures-san-diego/breast-implant-revision/.

Dr. Gregory Park is a board-certified plastic surgeon in the San Diego area, specializing in breast augmentation and breast implant revision surgery.