Today, I saw a breast augmentation patient in my Denver practice who has had multiple capsular contractions. This is a tough problem that only happens to a small percentage of people that undergo breast augmentation. But when it does, it’s very frustrating for both the patient and for me. I genuinely want every patient I see at my Denver practice to be happy and have no problems. But this just isn’t reality. Although I feel that I can keep complications to a minimum, capsular contraction is one that I just can not completely control. No plastic surgeon can. That’s why capsular contraction is one of the most prevalent topics discussed at national and international Plastic Surgery conferences.
After breast implant placement, the body forms a capsule (scar tissue) around the implant. It’s normally very soft and pliable, but in some people it hardens, thickens, and contracts. This is called capsular contraction. The prevailing theory behind this is based upon bacteria that incite the thickening; however, antibiotics provide no reduction in it’s incidence. The standard treatment is to surgically remove the capsule. There is no “scraping” involved. The scar tissue is meticulously dissected away from the surrounding breast tissue and removed. Then, the implant is replaced and generally, the contraction doesn’t redevelop. But in some people, it does. When someone gets recurrent capsular contraction, the management options are limited. In the past, completely removing the implants was the only definitive solution.
But now, there is another option. Strattice™ is a matrix of acellular, cadaveric, porcine, dermal graft. Basically, it’s re-engineered pig skin that can safely be used to drape around the implant and prevent capsular contraction. By placing it next to the lower portion of the implant, it does not allow the body to form the linear capsular scar that can tighten, lift the implant, and distort the breast. This is an exciting development. Although recurrent capsular contraction is the worst case scenario associated with breast augmentation surgery, it is no longer untreatable and the hope of implant preservation exists.
Have questions about capsular contraction? Leave them in a comment below!
Dr. Steven D. Vath
I am interested in a consult after reading that there might be something that can be done about my scar tissue.
Can this tissue be removed in case the patient decides to get an En Bloc surgery down the road?
If you have a capsular contracture – the capsule will be removed at the time of the capsulectomy. Your body will then form a new capsule around the implant, that, hopefully, will not contract again requiring another surgery.