Capsular contracture

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What is a capsular contracture?

In extremely rare cases, no matter how skilled the surgeon is, post-surgical complications can arise. Capsular contracture is a breast implant surgery complication. Fortunately, capsular contracture can be treated with a reconstruction surgery (capsulectomy), which keeps the visual appearance of the breast at its best.
Firstly, why does a capsule form around an inserted implant? When the implant is inserted, a patient’s immune system does not accept it as a natural body part, and instead, activates the body to form a fibrous capsule around the implant. The capsule naturally prevents the implant from moving inside the breast. However, sometimes the fibrous capsule can become constricted. This means that the capsule which surrounds the implant becomes so contracted and stiff that the volume inside the capsule becomes smaller than the volume of the implant, which results in tension, hardening, distortion, and pain in the breast.

Why does it happen?

Capsular contracture can happen to anyone after breast implant surgery:

  • It is more often seen in patients who had textured implants inserted. Rough texture of certain implants irritates the surrounding breast tissues, and so leads to the development of capsular contracture.
  • It is also known that the chances of capsular contracture development are higher after an infection to the operated tissues.
  • Seroma (serous fluid formation) and hematoma (blood collecting at the site of the surgery) may also contribute to the formation of capsular contracture.
  • Genetics play a significant role here, too because our genes determine the composition of the connective tissue. During pregnancy, for example, some women may develop severe stretch marks, while others may not have a single stretch mark at all. Therefore, people who are genetically predisposed to form more scar tissue can have a higher risk of developing capsular contracture.
What are the symptoms of capsular contracture?

Naturally, the breasts should feel soft and flexible. In case of capsular contracture, the affected breast becomes stiff, hard, and painful to touch. It can change its shape and look very unusual.

How is capsular contracture diagnosed?

Capsular contracture and its severity can be diagnosed based on physical examination alone. There are also different imaging techniques which provide more details about the patient’s condition, such as magnetic resonance imaging (MRI) which is also the most informative one.

What are the treatment options?

In case of capsular contracture, patients are usually offered a capsulectomy. It is a surgery which removes the contracted capsule (and the implant that is in it). During the same surgery, the cosmetic appearance of the breast can be reconstructed using smooth-surfaced implants or fat grafting technique (also known as fat transfer breast augmentation).