Capsular Contracture is a plastic surgery term for excessive scar tissue formation around the breast implant. the cause is not completely known, although excessive bleeding after surgery and possible bacterial contamination seem to be the leading causes. Although this is not a common complication, it can occur. There are several ways to avoid it, and they include
- incision choice
- antibiotic irrigation during surgery
- avoid excessive bleeding during and after surgery
- avoid infection
- breast implant massage after surgery
- possible use of anti-asthma medication
- use of ACDM/ acellular dermal matrix
Incision choice is made before surgery, and affects your chances of capsular contracture. the areolar incision is a great incision, but unfortunately, the ducts of the areola have bacteria that can’t be removed by surgical scrub or IV antibiotics. if possible, a breast fold incision should give a lower risk of capsular contracture in breast augmentation surgery..
Antibiotic irrigation during surgery, of the breast implant pocket, is very common. however, there is a specific recipe of antibiotics mixed together that have been proven to lower the risk of capsular contracture. Although this paper was published 5 years ago, some plastic surgeons are still not using the antibiotics as discussed in this paper.
Avoid excessive bleeding during and after surgery, and the lack of blood in the breast implant pocket will reduce the risk of capsular contracture. this is a reason why you should not exercise vigorously right after your operation- increasing your heart rate and blood pressure may cause excessive bleeding around your breast implant right after surgery.
Avoid infection after your procedure by taking antibiotics as directed and reporting to your plastic surgeon any problems that you may be experiencing regarding your breast augmentation procedure. Any infection will possibly cause problems with hardening of the tissue around your breast implants, and should be avoided at all costs.
Breast implant massage after surgery is one of the mainstays of treatment, and should be considered after your breast augmentation. the timing, amount, direction, and frequency of breast implant massage varies based on your plastic surgeon and personal preference.
Possible use of anti-asthma medication has been shown to reduce capsular contracture, assuming that it is given within a certain time frame after your procedure. These anti-asthma medications are thought to absorb and breakdown some of the chemical factors involved in causing the scar tissue around your breast implants to harden. Some medications may have side effects, and it is best to discuss the use of Singular, Accolate, and other medications with your plastic surgeon.
The use of ACDM/ acellular dermal matrix has been a recent development in cosmetic breast augmentation surgery. It’s been in used in breast reconstruction after mastectomy to help wounds heal and to give thickness to the breast tissue, and it is starting to be used more often in difficult breast augmentation cases with capsular contracture. There are several options, but most follow the strategy of removing all of a part of the capsular contracture, replacing the capsule with a sheet of ACDM, and then replacing the breast implant into the pocket. the end result, long term, should be no recurrence of any capsule