Many women who have breast augmentation surgery will not face any complications. But, a small number might have to deal with complications, such as capsular contracture, and it’s important to know how to recognize an issue and what to do if it does occur.
What Causes Capsular Contracture
When breast implants are put into place, the body’s natural response is to form a layer of tissue around them. Known as a capsule, the tissue is sometimes called scar tissue, although it isn’t exactly a scar. In most cases, the capsule causes no complications. But, it is possible for the capsule to shrink around the implant, squeezing and tightening in.
Often, an infection is to blame for the shrinking capsule. In some cases, the infection doesn’t cause any other symptoms, aside from capsular contracture, and even the smallest amount of bacteria in the area around the breasts during surgery can end up leading to capsular contracture later on.
The positioning of the implants can also make contracture more or less likely. Implants that are placed on top of the muscle have a greater risk for contracture than those put under the muscle. If the implants are inserted through the areola, there’s a higher risk of contamination and infection as well.
Symptoms of Capsular Contracture
Generally speaking, the symptoms of capsular contracture include a hardening of the affected breast or breasts. As the capsule shrinks around the implant, it constricts and squeezes it, causes the breast to feel firm to the touch. If the condition continues, the breasts can also become misshapen or deformed. It often takes some time for the condition to develop and for the symptoms to be visible.
There are four stages of capsular contracture. In the first stage, which can apply to any woman who has had breast augmentation, the breasts feel soft and look normal. In the second stage, the breasts become firmer, but there aren’t any visible changes to their shape.
By the time the implants reach the third stage of capsular contracture, they are beginning to look considerably distorted. The breasts might appear very round in shape or otherwise look different from the typical natural breast shape. In some cases, the position of the breast might be wrong. For example, the contracture can cause the breast implant to sit very high on the chest. In stage 3, the breasts feel very firm to the touch.
In the fourth and final stage of contracture, the breasts are very firm and the shape is very distorted. At this point, along with a change in the appearance and firmness of the breasts, a woman might also feel some pain or discomfort, particularly when the breasts are touched.
What Can Be Done If It Occurs
If capsular contracture occurs, the typical way of treating the issue is to remove or replace the implants. The surgery to replace implants is usually very short, taking fewer than two hours. Additionally, recovering after the surgery is usually easier than recovery after the initial breast augmentation procedure.
Depending on the stage of contracture a woman has, it might be recommended that the implants be completely removed and that she wait to have new implants put in. Postponing the addition of new implants gives the body time to heal and reduces the chance that contracture will occur with the new implants.
Ways to Reduce the Risk for Capsular Contracture
Before, during and after breast augmentation surgery, there are a number of ways that a patient and surgeon can reduce the risk for capsular contracture. First, keeping the implants as sterile as possible drastically reduces the chance for infection. To keep the implants sterile, they are usually left in their sealed, clean packaging until the last possible minute. The number of people who handle the implants is limited, to reduce the chance of any stray bacteria or other infectious agents coming into contact with them.
If a patient is receiving saline implants, which can be filled after they are placed in the breasts, a sterile system for filling the implants needs to be used. The saline must come from a sterile bag and flow through a sterilized tube, into the sterile implant.
Where the surgeon places the implants can also lower the risk for contracture. Generally, it’s agreed that putting the implants underneath the muscle reduces the chance of them becoming encapsulated, as they are less in contact with the tissue of the natural breast.
Finally, after the implants are in place, a woman can perform a number of massage and breast exercises to reduce the chance of contracture. Breast implant exercises help the implant settle into position and help the pocket that forms around it stay soft and supple. Initially, the exercises should be performed often, about every 30 minutes. After about six weeks, a woman should perform the exercises twice daily. It’s important to continue doing the exercises for as long as the implants are in place.
Working with a plastic surgeon who specializes in breast augmentation and who is recognized as a top surgeon can help a patient reduce the risk of capsular contracture. In Houston, Texas, Dr. Paul Vitenas has regularly been voted a top doctor and has received much recognition for his skill in performing breast augmentation. To learn more about the surgery and ways to reduce the risk of capsular contracture, call 281-484-0088 to schedule a consultation with Dr. Vitenas today.