What is capsular contracture and how to treat it?

The human body tends to create a scar around any kind of foreign object in the body, whether it is a pacemaker, breast implants, or an artificial hip.

Fortunately, complications from breast implants are very rare these days due to advanced surgical techniques and technology. But sometimes, no matter how skilled a plastic surgeon is, complications can still arise because everyone’s body and healing process is different and unique.

Learn more about the steps you can take to lower the risk of contracting capsular contracture, how to recognize the warning signs, and how to treat it if it happens to you.

What is capsular contracture?

Your body is smart. Your immune system will react when a foreign object has been detected and your body will attempt to isolate it by creating a barrier of scar tissue around it.

Capsular contracture can affect women with either silicone or saline implants. Depending on the different texture of breast implants used and your body’s reaction to foreign objects, the risk and severity of capsular contracture also differs.

Typically, when an implant is placed, your body naturally forms a harmless capsule of scar tissue around the implants. In most cases, this scar tissue remains soft, unnoticeable and helps to keep your implants in place.

Is capsular contracture dangerous?

While capsular contracture is generally not dangerous unless your implant ruptures, it can be quite painful and uncomfortable. In severe cases, it can change the shape and placement of your breasts as well. This can impair the quality of life and cause emotional distress.

Who is at risk of capsular contracture?

Up till now, the actual reasons why some develop capsular contracture while others do not are not well understood. That said, some risk factors that may increase the risk of developing capsular contracture includes:

• Breast trauma
• Previous radiotherapy to the breast
• Certain autoimmune disorders
• Genetic predisposition to scarring
• Surgical error
• Overly large implants
• Rupture of silicone implant
• Hematoma (build-up of blood where tissue was removed)
• When implant is placed on top of the muscle
• use of smooth (vs. textured) implants
• use of a silicone (vs. saline) filled implant 
• previous radiotherapy to the breast.

While there is no way to prevent capsular contracture from happening at all, there are ways to help lower the risk of it happening.

How to lower the risk of capsular contracture?

1. Choose the right implant size and type

One of the most effective methods to reduce capsular contracture risk is by choosing the right implant size and type for your body.

Getting overly large implants can increase your risk as going from an A cup to a D cup at once might affect your body’s ability to heal and get accustomed to your new breast size. If you have small breasts and want to go big, you should consider increasing size in stages instead.

Learn more about choosing the right type and size of breast implants here.

2. Avoid subglandular (above-the-muscle) implant placement

Although all types of implant placements can lead to capsular contracture, a submuscular placement, where the implant is placed behind the pectoralis muscle, leads to a lower risk, as compared to a subglandular placement (where the implant is placed above the pectoralis muscles).

By placing your implant under your chest muscles, you will only face 4~8% lifetime risk of capsular contracture as compared to 12~18% for a subglandular placement.

3. Quit smoking or at least stop smoking before your surgery

Smoking, either before or after your surgery, increases your risk of capsular contracture and infections. In addition, it also delays healing and recovery, and increases the risk of complications such as blood clots.

So quit smoking, or at least stop smoking for at least 3~4 weeks before and after your surgery.

4. Choose an experienced and skilled breast surgeon

The handling of an implant before insertion into the body can increase the risk of bacterial contamination. By getting an experience and skilled breast surgeon, you know t you’ll receive the highest level of care and safety standards.

5. Daily breast massages

Daily breast massages can improve healing, help implants settle in place faster, and prevent scar capsules from becoming hard. You might want to start doing daily breast massages about 4 weeks after surgery, for about 3 months, to lower the likelihood of the occurrence.

6. Avoid being overly active

Your new breast implants needs time to settle in place, so avoid squeezing, striking or any activities that can stress the surgical site at all. Avoid strenuous physical activities such as gym, weight lifting and any activities that can potentially cause injury to your new breasts for at least 2 months.

How to know if you have capsular contracture?

Capsular contractures can form quickly, but usually, it’s a very gradual process. Sometimes, it might be hard to notice the slight, everyday changes in your breasts until it’s too late. Here are several highly noticeable symptoms of capsular contracture:

• Hardened breasts – Breasts are more firm and hard than usual.
• High-riding breasts – Breasts appear to be significantly higher up on your chest than usual.
• Deformation of breasts – Breasts look distorted or has a ball-shaped appearance.
• Tightness of breasts – You start to feel somewhat tight in your breast area.
• Size of breasts become smaller – Capsular contracture will “squeeze” your implants, effectively making them look smaller.
• Asymmetry – Capsular contracture can sometimes happen to only one side of your breast.

Severity of contracture (based on Baker scale):

With MRI being the most accurate test in making the diagnosis, the Baker scale can also help, in a way, to determine how severe the contracture is:

• Grade I – Breast is soft, looks normal, and capsule is flexible.
• Grade II – Breast still looks normal, but is a little stiffened or somewhat hard to touch.
• Grade III – Breast is hard, looks distorted or becomes ball-shaped, and sits high up on your chest.
• Grade IV – Similar to Grade III but breast feels even harder and you start to experience pain.

If you begin to notice any warning signs or symptoms that may be associated with capsular contracture or other breast implant complications, you should either get it checked or call up your plastic surgeon asap.

How to treat capsular contracture?

1. Capsulectomy

2. Breast revision surgery

3. Massage, ultrasound and medications

4. Fat grafting

Conclusion

No doubt having bigger breasts can boost your inner self-confidence, enhance your sexuality, and help you dress better. But capsular contracture related to breast implants can be very uncomfortable and may even lower your quality of life.