Breast Revision – Solutions for Capsular Contracture

New research is helping to reduce the chances of capsular contracture

Capsular contracture is a condition where the body’s immune system reacts to a foreign object or material within the human body. This is most often associated with breast implants, however, joint implants have also been affected by this condition as well. According to published reports, capsular contracture occurs in approximately 15% of all breast augmentation cases. It occurs when the body forms collagen fibers around the implant in an attempt to isolate it from the rest of the body. When this happens the body begins to form a harden shell distorting the implants aesthetic shape resulting in complications of pain and discomfort.

Currently, researchers have been unable to find a specific cause for capsular contracture, however, there is very strong evidence that indicates it’s caused by bacterial infections. The infection is a bio-film that forms on the outer surface of the implant. There have also been reported cases of women getting capsular contraction after piercing their nipples.

New surgical techniques, to limit handling of the implant prior to insertion, have recently been developed, including a device that allows the surgeon to place the implant without ever touching it once removed from it’s sterile packaging. Typically, silicone breast implants have required considerable handling during insertion since it’s volume can not be altered – this required forcing the implant into the breast pocket by hand with some manipulation by the surgeon. This additional contact could possibly increase the chances that the implant could become contaminated.

Other methods used to reduce the chances of capsular contracture are:

  • Placing the implant in the sub-muscular position
  • Reducing contact of the implant with the chest wall prior to insertion
  • Using a multi-strong antibiotic solution on the surgical site

What treatments are available for capsular contracture?

  • Closed capsulotomy – which is the disrupting of the capsule using external manipulation – though rarely used now days since it could possibly rupture the implant.
  • Massage of the breast implant
  • External Ultrasound
  • Drug therapy
  • Electromagnetic field therapy
  • Breast revision surgery

Breast revision surgery offers the most reliable treatment and usually requires replacement of the breast implant as well.

About Edward H. Park

Dr. Park is a board certified plastic surgeon specializing in cosmetic and reconstructive plastic surgery.

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