American Society of Plastic Surgeons
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Breast Augmentation

Capsular contracture

BettyMarie Kinston, NC
3 months ago

What causes a capsular contracture after breast implants, and what has to be done to reverse the breasts feeling hard?


Steven Wallach, MD New York, NY
3 months ago
SURGEON PROFILE PROFILE

The most current theory is that it is due to a biofilm created by bacteria. Think of it like a low level infection over time. Treatment usually requires implant exchange and capsule removal.

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Mario Carranza-Garcia, MD Monterrey, N.L. - Mexico
3 months ago

completly d accord with dr wallach .

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Debra Johnson, MD Sacramento, CA
3 months ago
SURGEON PROFILE PROFILE

Several factors affect the development of capsular contracture: low grade bacterial contamination, as mentioned by Dr. Wallach, location of the implant (above the muscle more commonly tightens than below the muscle), type of implant (textured vs. smooth, and saline vs. silicone). Removal of the breast implants and and entire capsule is usually te recommended treatment. Changing the location of the implants can sometimes be helpful. Some surgeons also use acellular dermal matrix as "hammock" to try and break up the new capsule that forms. Some recommend taking a leukotriene inhibitor, like Montelukast, after surgery. A person with capsular contracture still has a higher risk of redeveloping a tight scar after surgery. Discuss with your surgeon the best way to try and reduce your risk and achieve soft breasts after augmentation.

Nelson Castillo, MD Atlanta, GA
3 months ago

Thank you for sharing your excellent question. CC typically occurs due to a low-grade infection on the surface of the implant, probably introduced at the time of placement through the incision site. That said, treatment involves removal of the implant and the hardened tissue. Hope this helps.

Elizabeth Morgan, MD, PhD, FACS Atlanta, GA
3 months ago

I am sorry this has happened. Capsular contractures form in response to tissue irritation around the implant. The most common source of irritation is a biofilm a layer of bacteria that irritate the tissues. Treatment often starts with a medicine called Singulair (or Accolate) which may soften the capsule. If this doesn't work, then surgery may be needed. It removed the capsule, usually places a new implant in a new position and often covers the implant with an acellular dermal matrix to reduce the risk of capsular contracture return.




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