October 12, 2009
The typical scenario goes something like this. You have her breasts augmented and, at first, the implants are too high and the look a bit artificial. But as the months go by and the implants settle, your breasts attain a more natural and softer look. For most patients the rest is history. But for some, it’s not that easy.
Over time, anything implanted into your body will become surrounded by a scar capsule. With sufficient massage, this capsule generally remains soft and pliable and essentially unnoticeable. But in some cases, it can contract down and change both the look and feel of the implant and of your breast overall. This process of capsular contracture can leave either one or both of your breasts feeling firmer and looking anything but natural. And although many women may feel an occasional ache or pain in their breasts, capsular contracture can eventually lead to significant discomfort.
And so can anything be done or do you simply have to live with this? The good news is that capsular contracture can often be treated in a very straightforward manner. Although several factors may lead to its development, we do know a few prime causes. Surgeons used to wear powdered gloves during surgery but this powder was found to be an irritant and a strong factor in the development of contracture. And so now the standard of care is to wear powder-free gloves. Blood around the implant is also known to increase the risk for contracture and so effort is taken to minimize the amount of blood in contact with the implant and tissues both during and after surgery. Recently, chronic bio-films were suggested to be a factor in the development of contracture. Simply said, these films are produced by low levels of bacteria which colonize on the implant and then surround and protect themselves from the immune system by a thin film shield. Because of this finding, many surgeons (including myself) will replace the implant with a new one even if it grossly appears intact. The capsule is then removed (either completely or in part) or incised to allow the pocket containing the implant to soften and expand. The result is restoration to a much softer and more natural look and feel…all in little over an hour and with very little downtime.
Although the rate of capsular contracture has dramatically decreased over the years due to advances in both implant design and surgical technique, it can still occur and should be addressed by a Board Certified Plastic Surgeon who specializes in aesthetic surgery of the breast. If you feel that you either have or may be developing symptoms of capsular contracture, please contact myself or my staff to schedule a consultation. This process does not improve with time and can be easily treated. I look forward to working with you.
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