Is it possible to prevent capsular contracture?

capsular contracture prevention

No operation is ever entirely risk-free and complications can occur no matter how skilled the surgeon is, simply because it is impossible to predict how someone will respond to surgery. The physiological differences affect how quickly they heal and also affects how likely they are to develop complications following surgery.

Scarring after surgery is particularly difficult to predict. Some patients suffer from keloid or hypertrophic scarring, where an overproduction of collagen means the scar tissue exceeds the original wound, resulting in a large, raised, hardened scar.

There is also a form of internal scarring that can present as a complication after breast implant surgery. Known as capsular contracture, it roughly affects less than 10% of patients in the first few years after surgery to some degree.

What is capsular contracture?

This complication is caused by the patient’s ability to grow scar tissue. In ‘normal’ cases, when a wound or incision is made then the body works to repair itself. It creates scar tissue, which is firmer and harder compared with the original tissue. When a patient has a breast enlargement, the body will react to the operation by creating scar tissue around the wound and the foreign bodies it detects – the implants. Normally, this is actually a good thing. The harder, firmer tissue actually helps keep the implants in place.

For patients who experience more significant capsular contracture, however, the scar tissue forms too tightly around the implants, which can compress them, change their appearance, make the skin look or feel uneven and sometimes may even cause discomfort. The degree of capsular contracture can be graded:

Grade 1: very mild capsular contracture that often the patient is unaware of. The breasts remain soft to the touch and there is no change to their shape.

Grade 2: the patient may be aware of very minor cosmetic changes to the breast. The shape is still relatively normal, and the breasts may feel slightly firmer to the touch.

Grade 3: the patient notices obvious cosmetic symptoms including changes to the breast shape and the breasts feel very firm.

Grade 4: the breasts feel very hard and misshapen and the patient will usually experience a degree of discomfort.

Is capsular contraction prevention possible?

The good news is that the risk of serious complications follow cosmetic surgery is really rare. The advances in medical technology in the decades that these procedures have been practised for have ensured that the medical profession are extremely skilled and proficient in the procedures that they carry out. Coupled with this, advanced in medication, pain relief and antibiotics have improved, as has our understanding of pre-care and after-care.

In regard to capsular contracture prevention, there are certain steps your plastic surgeon can take to minimise the risk.

  • Using the correct size of implant for your body shape and frame: placing a too large implant in a patient with insufficient breast tissue can increase the risk of capsular contracture
  • Type of implant material: gel implant with a textured surface rather than a smooth surface is thought to lower likelihood of developing capsular contracture
  • Implant placement: placing implants under the muscle also reduces the risk
  • Minimal implant handling: it’s now thought that a low-grade bacterial infection can be introduced to the breast cavity during surgery and this creates a ‘biofilm’ around the implants. By reducing the handling of the implant during surgery, the lower the risk of this bacterial contamination occurring. A recent study found that the use of a Keller Funnel to insert the implant significantly lowered the risk of capsular contracture

For more advice on breast implant surgery and capsular contracture prevention, call 020 7118 6887 to speak to the experts at the Clarence Clinic.