What is Breast Implant Capsular Contracture and how can it be treated?

Capsular contracture is the phrase used to explain scar tissue that forms around breast implants triggering the breasts to harden, feel firm, and sometimes painful to touch.

This happens as a result of internal scar tissue developing a tight capsule around a breast implant that is firm and painful.

Symptoms of Encapsulated Breast Implant

Capsular contracture is usually spotted upon physical examination by a plastic surgeon.

However, its symptoms in most cases develop gradually. They occur within the first two years following surgery.

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If you develop a breast implant capsular contracture more than two years after augmentation, then there is a probability that it could be an implant rupture.

To know how severe the capsular contracture is, the Baker grading system is used. According to the system, there are four levels of capsular contracture, namely:

• Grade 1: This does not show any alarming symptoms. But it can be identified by a professional plastic surgeon upon examination.
• Grade 2: At this grade, slight aesthetic symptoms can be spotted. The breasts become fairly firm when you touch them.
• Grade 3: At this grade, apart from breasts firming when touched, they seem odd: they will be excessively round, and the nipples may be malformed.
• Grade 4: Apart from the symptoms shown in grade three, at this grade, the breasts become sore, tender and painful to the touch.

This should not be the ideal scenario. You should always be on the lookout for any of these signs. Soon after you notice any sign, quickly visit your plastic to have your breasts examined.

What causes Capsular Contracture?

Studies show that about one in six breast enlargement surgery patients experiences some degree of capsular contracture.

It is a rare condition. Causes of capsular contracture vary from person to another.

it is not unique to breast augmentation surgery; it can develop after any kind of invasive surgery.

The exact causes of this condition are not entirely known. However, there are many theories trying to explain the cause.

• Genetics Theory: According to different researches conducted, genetics is believed to determines if one develops capsular contraction or not. Those who have a family history of autoimmune disease are likely to develop this condition.
• Biofilm Theory: Biofilm is a thin layer of bacteria that develops around implants after staph bacteria is introduced to the breast cavity during surgery. It is believed to be the cause of capsular contracture. This is based on a study that was done on pigs. It was found that pigs with staph bacteria had high chances of developing capsular contracture than those that were not.

Other causes of capsular contracture include

• Postsurgical complications like a bacterial infection.
• Autoimmune disorders.
• Use of oversize implants or insufficient skin coverage.
• Leaching of silicone molecules into the pocket holding the implant.

Capsular contracture treatment

Unless the implants rupture, capsular contracture is not usually harmful. It is highly treatable.

Some of the many ways of treating it include:

1. Squeezing the Affected Breasts and Implants.

Squeezing of affected breasts, to break up the scar tissue capsule, was once the only way of treating this condition. However, this results in further complications.

2. Aspen multi-energy Therapy.

Currently, Aspen multi-energy therapy, which is noninvasive,  is mainly used to treat capsular contracture.

This is achieved by applying the Aspen harmonizer to the patient’s breast tissue; no incisions are made.

The therapy is usually administered over two to three weeks. However, it is only effective for grade two and three cases of capsular contracture.

It cannot treat grade four cases.

Generally, there are no studies to prove the effectiveness of the above treatments.

The only sure treatment of capsular contracture is the permanent removal of the implants and surrounding scar tissue.

Capsular Contracture Prevention

This complication can be prevented using several methods which include:

• Comprehensive patient screening: Before the surgery, breast implant patients should be screened for health conditions that might increase their risk of complications like hematomas. Patients that smoke should give up on smoking, as smoking makes hematoma formation more likely and generally impairs the healing process.
• Using the correct size of implant for the patient: Too large implants in a patient with inadequate natural breast tissue to cover the implant increases the risk of capsular contracture.
• Minimal implant handling: This is also referred to as ‘no-touch’ technique. According to this technique, prior to being inserted into the patient’s breast, an implant should be handled by only one person. It is also advisable that Board-certified plastic surgeons work in a sterile hospital facility. In this way, there can be little chance of surface contaminants on the implants once they are inside the body.
• The use of textured gel implants: This reduces the chances of capsular contraction because the textured implants make it more difficult for thick scar tissue to develop around the implant. However, this is not recommended for every patient. Use of textured implants is most suitable for sub glandular breast surgery.
• The use of “under the muscle” placement: This method of implant placement has proved to result in an 8-12% lifetime risk of capsular contracture.
• Massage: Massaging the breasts after the breast augmentation surgery may or may not help to prevent capsular contracture. However, there are no studies to prove the effectiveness of this method.
• Use a closed filling system: Closed filling system eliminates any possibility of foreign bodies entering the implants. Doctors recommend it because it reduces the potential of getting capsular.

Conclusion

Anybody planning to go for a breast augmentation surgery should:

• Ensure that the surgeon carrying out the procedure is certified by the board of surgeons.
• Give detailed information about your health and family background to check if the surgery is good for you.
• After the breast augmentation, make regular visits to the surgeon for checkups.