Capsular Contracture: What It Is and What the Right Surgeon Can Do to Fix It

We think of scarring as a bad thing, but your breast augmentation surgeon plans for a certain kind of “good” internal scarring, called a capsule, to form around your breast implants as you heal. The scar tissue capsule actually keeps breast implants in place, just the way your surgeon intended. It is the body’s natural reaction to something that is not you.

Sometimes, however, the capsule of scar tissue can thicken abnormally and tighten around one or both breast implants. This condition is called capsular contracture, and while it looks alarming it is, thankfully, very treatable. Today we’ll discuss the ins and outs of this frustrating complication, and how we can help patients overcome it at Granite Bay Cosmetic Surgery.

The how, what, why, and when of capsular contracture

About 10% of women develop capsular contracture in one or both breasts. The capsule of scar tissue around the breast implant becoming firm to the touch is the first sign that you may be developing the condition. Some patients only experience a moderate tightening, but in more extreme cases, the breasts will appear overly-round, extremely firm, and tight against the chest. Additionally, the nipples will become distorted, and the breasts may appear asymmetrical.

If you think you may have capsular contracture, the first person to call is your original plastic surgeon. If you prefer to find a new plastic surgeon or cannot return to the surgeon who performed your breast augmentation, and are in the Granite Bay area, we would be happy to see you—whether or not we performed your initial breast augmentation. Call our office at (916) 242-2662, and we will schedule your appointment as quickly as possible.

The causes of capsular contracture are largely unknown

Capsular contracture typically isn’t dangerous—just incredibly frustrating. This is especially so because there is no single known cause and it can happen to anyone, even under the care of experienced plastic surgeons.

While there is no guaranteed way to prevent capsular contracture, breast plastic surgery specialists are more likely to be aware of the latest research and use techniques that can help reduce the frequency of this complication.

That said, there are circumstances that are more likely to foster capsular contracture. You are more likely to develop capsular contracture if your implant has ruptured, or if you developed a seroma. The causes seem to vary from individual to individual, with studies that suggest multiple causes exist, including genetic predisposition to abnormal scarring, autoimmune disease, or a biofilm (low-grade bacterial infection) that forms on the outside of the implant.

Reduce the risk of capsular contracture by choosing an experienced surgeon with research-driven practices

While there is no guaranteed way to prevent capsular contracture, breast plastic surgery specialists are more likely to be aware of the latest research and use techniques that can help reduce the frequency of this complication. For example, here at Granite Bay Cosmetic, we know that capsular contracture is less likely when implants are placed under the muscle (submuscular, rather than subglandular) using the Keller Funnel implant placement method to reduce the amount of time spent handling implants. We avoid periareolar incisions, which are associated with a higher rate of capsular contracture, and instead recommend inframammary fold (IMF) incisions for most breast augmentation procedures. We also use antibiotic irrigation during surgery.

Capsular contracture is most likely to occur in the first two years after breast augmentation with implants

Most cases of capsular contracture arise in the first few years after a woman’s breast implants are placed, and there are various degrees to which the scar capsule may contract. In minor cases, you may feel almost no physical symptoms, but in extreme cases, capsular contracture can be uncomfortable or even painful. (In cases where capsular contracture happens later, it can be due to an implant rupture, and should be evaluated.)

Surgical technique is key in treating capsular contracture

When capsular contracture occurs, the most effective way to treat it is with breast implant revision surgery, an umbrella term that includes multiple types of surgery. Which version will be most beneficial will become clear after your plastic surgeon sees the condition of your capsule and implant, so the exact surgical plan will need to remain somewhat flexible. Taking into consideration your capsule and surrounding tissues, we may remove the implant and leave the scar tissue capsule in place, or remove the implant and part of the capsule. Other patients may require total capsulectomy to remove both the implant and the entirety of the scar tissue capsule.

Capsular contracture can feel and look scary, but in our experience, most patients are very satisfied after breast implant revision surgery, enjoying attractive results and a resolution of all symptoms.

If any implant malposition has occurred, meaning that the implant moved from its original position, breast implant revision surgery will also involve repair to the breast pocket, where the new implant will sit. All of this ensures that you get a beautiful result from your second surgery.

While we can place new implants, some patients may choose to remove the implants without replacing them, returning their breasts to their pre-augmented size. In some cases, if the skin doesn’t have the elasticity to return to position, a breast lift will be recommended. This allows us to correct any sagging and restore firmness, position the breasts symmetrically, and create a more attractive shape.

Whatever surgical path is best for you, have hope! While capsular contracture can feel and look scary, in our experience, most patients are very satisfied after breast implant revision surgery, enjoying attractive results and a resolution of all symptoms.

How to choose a surgeon for breast implant revision

Capsular contracture revision requires a precise set of surgical skills and an expert understanding of breast tissue and implants. Choose a surgeon who has experience with breast augmentation revision surgery after capsular contracture, and can show you before and after photos of previous patients who have had excellent results after revision surgery. Here are some other things to look for in your surgeon:

• Board certification with the American Board of Plastic Surgery (ABPS)
• Excellent references from previous patients
• AAAASF-accredited surgical center
• Evidence of beautiful surgical results in their before-and-after photo gallery
• A willingness to discuss risks and complications
• Demonstrated interest in you, from your medical history to your desired aesthetic outcome

Above all else, choose a surgeon who prioritizes your safety.

Visit Granite Bay Cosmetic Surgery’s understanding, highly-qualified plastic surgeons

You deserve to love your breasts! If you suspect you have capsular contracture, we encourage you to call a plastic surgeon with proven experience correcting this condition.

For those in Sacramento, Granite Bay or the surrounding areas, we are here to help! Contact us online or call (916) 242-2662 to set up a consultation with one of our female plastic surgeons. We look forward to being there with you, every step of the way.