woman checking breast for capsular contracture

Let’s Talk About Capsular Contracture in Breast Implants

It’s a nightmare situation for many women who choose to undergo a breast augmentation.

The breasts feel hardened or may look different and cause discomfort.

This condition, known as capsular contracture, is one of the most common reasons for people with implants to undergo additional corrective surgery.

What is Capsular Contracture?

Although the exact cause of capsular contracture is not fully understood, it is likely an immunologic response to foreign materials, such as an implant or bacteria in the body.

Tight collagen fibers create a capsule by an immune response to the presence of the foreign implant. This collagen-fiber capsule squeezes the implant as it tightens and can lead to shape and position change and even discomfort and pain.

How to recognize capsular contracture

Some women notice an increased firmness in the breast several years after surgery – although, signs of capsular contracture can occur a few months post-surgery.  It takes some time for the capsule to form and to contract. The implants themselves don’t get firm – but a tissue capsule around the implant becomes dense and tightens the implant.

Patients will experience a firmness, pain, or a change in the position of their breasts due to capsular contracture. For example, the implant may sit in a much higher position on one breast with capsular contracture compared to the other breast.

Capsular contracture can be graded on the 4-point Baker Scale:

  • Grade I —  The breast appears natural in size, shape, and softness.
  • Grade II — the breast appears normal but maybe slightly firm.
  • Grade III — the breast appears abnormal and is firm.
  • Grade IV — The breast is painful to touch and appears abnormal and firm.

In extreme cases of capsular contracture, the capsule formed around the implant can be almost rock-hard. When the implant is removed, surgeons can cut the capsule away from the implant. The hard capsule can cause a distortion and an unnatural appearance in the breast. Some people describe it as tennis balls underneath the skin.

Even before this extreme hardening, if you feel that your breast implants aren’t as soft or don’t sit quite right, the problem may be capsular contracture.

Ways of preventing capsular contracture in breast implants:

There are certain things a plastic surgeon can do during the breast augmentation procedure to minimize the risk of capsular contracture including:

  • submuscular breast implant placement
  • use of textured implants
  • limited handling of implants and skin wall before insertion of implants
  • cleaning the surgical site with antibiotic solutions

With these no-touch and sterile techniques, the rates of capsular contracture have decreased.

Treatment for capsular contracture:

Treating capsular contracture always depends on the individual case-by-case basis. It’s important to speak to your plastic surgeon for the best form of treatment.

With mild cases of capsular contracture, some plastic surgeons will recommend a type of massage or even medications that may help treat the condition.

Removing the implant is the most common way to treat advanced capsular contracture. The implant can be replaced, or in more extreme cases, the implant is replaced after a delay to lower the risk of the capsule forming over the new implant.

To learn more about capsular contracture or to discuss the risks with Dr. Bowman, book a consultation. If you suspect you may have a case of capsular contracture, talk to your plastic surgeon. Capsular contracture doesn’t get better over time – it can get worse.

About Fairview Plastic Surgery & Skin Care Centre: Dr. Cameron Bowman is a fully trained aesthetic and reconstructive plastic surgeon. His practice is located at Suite 480 – 999 West Broadway, Vancouver, BC V5Z1K5. Contact him at 604.734.1416 or www.fairviewplasticsurgery.com