Capsular Contracture

As a normal part of the healing process, your body creates a scar around a breast implant. This is the case for any type of implant (such as a prosthetic joint replacement) or foreign body (such as a piece of pencil lead). Your body naturally encapsulates the implant/foreign body by creating a scar around the entire thing. A normal scar or capsule is not harmful to your health. A normal capsule (scar) is thin, soft, and does not negatively impact the shape, position, or feel of the breast.

If the capsule (scar) around a breast implant thickens too much, it can cause problems. This finding is called capsular contracture. The most common issue with capsular contracture is thickening and tightening of the scar around the breast implant. This can cause the breast to feel firm to the touch but may still look normal in shape. The breast feels firm because the capsule over the implant is firm. The implant underneath the capsule is likely still as soft as it was when it was initially placed.

If the capsular contracture worsens, then the capsule (scar) may squeeze the implant and cause it to move in a particular direction. The breast may feel firm to the touch and may look like the implant is too high, too round, or may distort the overlying breast/nipple tissue. The shell of the implant may fold on itself and create a weak spot which can increase the risk of implant rupture. Rarely, the most severe version of capsular contracture can cause discomfort as well.

The vast majority of capsular contracture cases occur within 1-2 years of breast implant placement. When capsular contracture happens long after breast implant placement surgery, it is often due to the implant being ruptured. Unfortunately, capsular contracture has a high recurrence rate and may require several different approaches to try and minimize the chance of it coming back.

Dr. Rodriguez will recommend a specific surgical plan based on your situation, the severity of your capsular contracture, and your goals.

Since capsular contracture has a relatively high recurrence rate, Dr. Rodriguez may recommend a combination of the following treatment options:

While we don’t understand all the details of how capsular contracture, we know several risk factors for developing it, including:

Dr. Rodriguez takes precautions to mitigate these risk factors and minimize your risk of developing capsular contracture. These precautions include:

After surgery to treat capsular contracture, you will have a wrap placed around your chest during surgery and will switch to a supportive, soft sports bra at your first follow-up appointment. You should not wear an underwire bra until cleared by Dr. Rodriguez. Most patients can return to work by 2 weeks after surgery and can start exercising again 6 weeks after surgery.

There is evidence to suggest that an asthma and allergy medication called montelukast (Singulair) can help reduce the chance that capsular contracture develops or worsens. Vitamin E may also be helpful to discourage the capsule from thickening. Dr. Rodriguez may recommend these as part of your comprehensive treatment plan, along with other measures like breast implant massage.

If capsular contracture is going to come back again, it is most likely to happen within the first 1-2 years after the surgery. It will not be immediately evident in the first few weeks after surgery. That is why it is important to return for all follow up appointments with Dr. Rodriguez to have your implants checked for signs of capsular contracture.

A silicone product, such as silicone sheets or silicone gel, is recommended to optimize the appearance of the scars on the breast skin.