Capsular contracture is one of the most common issues women face after a primary augmentation, which can lead to pain and disfigurement. This blog discusses capsular contracture, what it looks and feels like, and what options patients have for avoiding it and treating it.
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Post-Augmentation Problems
Breast augmentation is one of the most popular cosmetic procedures performed, and for the most part, patients are happy with their results. But sometimes, through no fault of their own, patients experience adverse breast augmentation effects that make them regret their decision. One such issue is capsular contracture, which affects the appearance of breast implants and can even cause physical discomfort.
Below, we’ll discuss capsular contracture, how to recognize the signs, and what to do about it.
What Is Capsular Contracture?
Capsular contracture is the most common complication following breast augmentation, and while researchers aren’t sure exactly what causes it, they agree that it’s likely caused by multiple factors.
Recent research has shown that neither saline nor silicone shells are inert—meaning that your body’s immune system is responding to the shell and its degradation products. This “implant debris” has significant pro-inflammatory effects, resulting in a foreign body reaction and an implant capsule. Tightening of this capsule, through myofibroblasts, results in capsular contracture.
Overall rates of capsular contracture are between 5% and 15% of patients. What we do know is this: Capsular contracture is the formation of fibrous tissue, sometimes called scar tissue, around the implant, which is a normal biological response that happens whenever a foreign body (like an implant) is inserted into the body. A small amount of protective tissue is natural and doesn’t cause harm.
The problem with capsular contracture is that an overgrowth of fibrous tissue, more specifically myofibroblasts, eventually tightens and constricts the implant, causing the breast to look misshapen and become overly firm and painful. In these cases, breast revision surgery, or en block capsulectomy, is the best way to remedy the problem.
Potential Causes of Capsular Contracture
Despite extensive research, the direct causes of capsular contracture are unclear. Researchers have studied the tissue and found that it is made up of collagen, which is partly responsible for healing. Because the capsule is the body’s response to a foreign substance, it is considered an immune response; whenever something is placed in the body, it reacts as if it is harmful. By encapsulating the breast implant in a cocoon of scar tissue, the body attempts to contain any potentially harmful substances within that scar tissue.
So why do some women experience a normal amount of scar tissue while others have too much that causes issues like capsular contracture?
While we don’t know the exact reasons, clinical studies have narrowed down some factors that make patients more likely to experience capsular contracture than others:
- Hematomas or infections. Because capsular contracture is an immune response, when post-surgical issues arise, such as infection or broken blood vessels (hematomas), the immune system jumps to respond. It’s believed that because there is a higher concentration of patients that have had both post-surgical issues and later developed capsular contracture, the capsular contracture is related to an overactive immune response.
- Prior radiotherapy. Post-mastectomy patients who undergo radiotherapy to combat breast cancer and implant-based breast reconstruction experience a much higher rate of capsular contracture, which often results in needing subsequent surgeries.
Early Signs of Capsular Contracture
Capsular contracture shows up at varying times for patients, although most start to notice changes around three to six months post-surgery. It is also common to show up in later years. Early capsular contracture signs include:
- Breasts that sit high up on the chest
- Misshapen or unevenly shaped breasts
- Breasts that feel firm or tight
- Overly round or ball-like shape to the breasts
- Pain or discomfort
What Does Capsular Contracture Feel Like?
Patients with capsular contracture experience feelings of tightness in their breasts as if the implant is being squeezed. Their breasts also commonly feel very firm, tight, and round, like a tennis ball or baseball.
One of the difficulties with capsular contracture is that many of its early symptoms overlap with typical breast augmentation recovery symptoms. Breast augmentation patients are told to expect a period of recovery in which the implants settle. When implants are first inserted, the body reacts by swelling around them, causing a squeezing sensation. This results in the breasts sitting higher on the chest and being firm to the touch. As the body relaxes around the implants and swelling reduces, the implants drop to a more natural position and a more natural feeling.
The drop process can take up to eight months to complete, which can make patients concerned that they might have capsular contracture.
How to Prevent Capsular Contracture
Unfortunately, the only sure way to avoid capsular contracture is to not get a breast augmentation with implants. There is simply no sure way to avoid this complication with traditional implants. Your best bet is to voice your concerns with your plastic surgeon and have them help you vet the best options to avoid the complication. But again, there is no guarantee.
If you are very concerned with capsular contracture and want a modest increase in cup size, you may want to consider a natural augmentation or a breast augmentation with fat grafting. This procedure avoids implants altogether and increases the size and shape of the breasts using autologous (your own fat) fat transfer.
How to Address Capsular Contracture
The best way to address capsular contracture is through a secondary procedure. This condition does not go away on its own, and minimally invasive treatments are ineffective in the long term.
If you have capsular contracture, you may need to undergo a procedure called breast implant revision, which allows your plastic surgeon to remove breast implants and the breast capsule, and if you elect, they can replace your old implants. However, if you do not want to undergo a secondary augmentation procedure, you may wish to undergo total correction explantation surgery from Dr. Strawn in Newport Beach, CA. Dr. Strawn’s signature procedure includes the removal of the breast implants and capsules, a breast lift, and a natural augmentation with fat grafting for an all-natural, youthful result.
Want to Learn More About Breast Revision in Newport Beach, CA?
Dr. Strawn is an explantation super-specialist in Newport Beach, CA, focusing on the aesthetic improvement of a woman’s natural breasts after removing breast implants. If you have capsular contracture, BII, or any other breast implant complications, Dr. Strawn and his team are here to support your needs. For an in-depth consultation, call Scultura Plastic Surgery today at (949) 612-7231 or fill out the contact form to get started.
