Capsular contracture is an abnormal scar tissue layer that sometimes forms around breast implants causing discomfort and firmness. Capsular contracture can also cause the breasts to appear distorted or asymmetric. Capsular contracture is one of the most common problems encountered after breast augmentation and can require additional surgery to repair.
When a breast implant (or any device) is placed in the body, a thin layer of scar tissue known as a capsule develops around the implant. This is part of the normal healing process. However, if that capsule layer develops excessively and tightens around the breast implant, it is called “capsular contracture.” The main causes of capsular contracture are inflammatory reactions due to infection or bleeding. Infections that cause capsular contracture may occur from the breast implant surgery, from an infection elsewhere in the body such as the urinary tract, or even following dental work. A rupture in a silicone gel implant is another common cause of capsular contracture.
A classification system has been developed to describe the severity of capsular contracture ranging from mild to severe. Mild cases of capsular contracture with no symptoms or visible deformity may not require additional surgery. More severe cases of contracture that cause visible or palpable firmness, pain, displacement, implant rupture or deformity usually require additional surgery.
A “capsolotomy” is a surgical procedure that involves releasing (rather than removing) the capsule. This technique is generally reserved for mild cases of contracture to improve breast symmetry. A “capsulectomy” is a surgical procedure performed by removing the scar tissue capsule layer. This procedure is recommended in cases with thick, calcified capsules. There is also a variety of medications that are being investigated to treat contracture such as Accolate (Zafirlukast) and Singulair (Montelukast), but nothing to date has been FDA approved.
The best treatment of capsular contracture is to avoid getting this problem in the first place. Precise surgical technique with no bleeding and my “no-touch” placement of the breast implant has enabled me to keep capsular contracture to a minimum in our practice.