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Capsular Contraction

Capsular contracture is one of the most common complications of breast augmentation with implants. This condition can result in distorted, sometimes hard and painful breasts. Severe capsular contracture may require surgery to treat and resolve the condition.

Tracy Pfeifer, MD is an aesthetic plastic surgeon in New York City with a medical practice focused on breasts. Dr. Pfeifer performs all types of cosmetic breast surgery, including surgical treatment for capsular contracture. If you suspect that you are suffering from this condition, call our office as soon as possible to schedule a consultation.

After breast implant surgery, the body produces tissue surrounding the implant known as a capsule. Normally, this tissue is thin, almost transparent in some cases. The capsule is larger than the implant, allowing room for motion. With capsular contracture, the capsule thickens and tightens, making the space for the implant increasingly smaller. The implant may rise to a higher position, or the breast may look artificially round. In the worst cases, the capsule can become so small that the implant is hard and painful.

Severity of capsular contracture is graded according to what is termed the Baker Scale:

  • Grade I: The breast is still normally soft with a natural appearance in size and shape.
  • Grade II: The breast is somewhat firm, but appears normal.
  • Grade III: The breast is firm and abnormal in appearance.
  • Grade IV: The breast is hard and painful to the touch with abnormal appearance.

Under the muscle implant placement and careful handling and filling of implants can help prevent capsular contracture. Once it has developed, limited treatment options include:

  • Capsulectomy: The usual treatment for severe capsular contracture is capsulectomy – complete surgical removal of the scar capsule. Once the capsule is removed, a new capsule will form around the implant, ideally with no tightening and contracting. Although this surgical procedure may not completely eliminate the possibility of reoccurrence, compared to other methods, it has been shown to reduce the risk of future capsular contracture.
  • Capsulotomy: This is another surgical procedure with a somewhat lower success rate than capsulectomy. In involves incising the capsule in various areas, increasing its overall capacity and allowing the implant to move around in the space.
  • Medication: Some studies have shown that, for some patients with capsular contracture, Zafirlukast (Accolate) may soften scar tissue around the implants, soften the breasts dramatically over a period of months, and decrease reoccurrence of the condition in patients undergoing surgery to treat it.
  • Massage: Once capsular contracture begins, massage and/or a compression bandage or garment may help reduce the severity. The goal is to prevent the capsule from becoming excessively hard and to prevent the implant from becoming fixed in an upward position.

After undergoing surgery to treat capsular contracture, your recovery period will be similar to your original breast implant surgery – 1 to 2 weeks depending on the placement of the implant. We recommend no heavy lifting and avoiding strenuous exercise for a period of 2 weeks after the surgery.

Any surgical procedure carries some risk of complications, and with breast implants, capsular contracture is perhaps the most common serious complication. If you have developed capsular contraction with your breast implants, Tracy Pfeifer, MD can help. Call our New York City office to schedule a consultation and evaluation.