Woman holding breast implant

A capsular contracture is a complication that sometimes occurs due to breast implants. After your implant is put in place, fibrous scar tissues form around it. This creates a protective capsule, your body’s natural response to a foriegn object. In most circumstances, the capsule is soft and barely noticeable. 

However, in rare cases, the tissue capsule that forms is unusually hard and dense. It goes on to tighten and squeeze the implant, which can cause issues like pain and distortion in breast shape. 

It is unclear why capsular contraction occurs in some patients and not others, although certain factors – like a family history of autoimmune disease – may put you at heightened risk. If you do experience capsular contracture, do not panic. There are many treatment options available that can effectively correct the issue. 

What Are The Types Of Capsular Contracture? 

The severity of capsular contracture varies and is broken down by a grading system. 

Grade 1

Grade 1 capsular contraction produces or shows no symptoms. Scar tissue appears around the implant, but does not interfere with the size or shape of your breasts. It typically does not require treatment and you may not even notice. 

Grade 2

Grade 2 capsular contraction is characterized by mild cosmetic symptoms, meaning your breasts may feel somewhat firm to the touch. This may or may not require treatment if it does not cause you significant discomfort or distress. 

Grade 3

Grade 3 capsular contraction has obvious cosmetic symptoms. Not only will your breasts be firm to the touch, they will also appear abnormal. This can include things like misshapen nipples or overly round breasts. This typically requires treatment, but usually does not cause pain. 

Grade 4

Grade 4 capsular contraction can have many of the same cosmetic issues as lesser forms, such as hard or misshapen breasts. However, it can also be painful. Breasts may be perpetually sore or painful to touch. 

Who Is At Risk For Capsular Contracture? 

Anyone who gets breast implants is at risk of capsular contraction, but it may be more likely to occur if you have certain risk factors. However, studies are not conclusive and some individuals still experience capsular contracture even with an absence of risk factors. 

Capsular contraction may be linked to genetics. If you have a family history of autoimmune disease or a genetic predisposition to scarring, you may be at an increased risk. 

Some evidence also indicates that women who have undergone radiation therapy may be more likely to develop capsular contracture. 

Implants themselves do not cause capsular contraction. Saline implants only contain saline solution, which can be safely reabsorbed by the body, and silicone gel implants use medically inert silicone. Capsular contraction can happen with any form of medical implant. It is not associated with breast implants specifically. 

How Do I Treat Capsular Contracture? 

Corrective Surgery 

If you choose to treat capsular contraction via corrective surgery, you have three options: a capsulectomy, an open capsulotomy, and autologous reconstruction. 

During a capsulectomy, your surgeon removes both the implant and the tissue capsule. They then insert an implant wrapped in dermal matrix material, a skin substitute made up mostly of collagen, which occurs naturally in the body. This reduces the risk of a second capsular contraction. 

During an open capsulotomy, your surgeon cuts open the tissue capsule via a small incision. This allows the capsule to pop open, reducing discomfort and cosmetic symptoms. Depending on your specific condition, your surgeon may also replace the implant. 

Autologous reconstruction is a process by which your surgeon removes the implant and reconstructs your breast with tissue transplanted from another area of the body. This eliminates the risk of recurrent capsular contraction as capsules will not form around transplanted tissue. The major drawback, however, is that autologous reconstruction is a much more complex surgery than other options and comes with a longer recovery period. 

Non-Surgical Options 

A new procedure, Aspen Therapy, is a completely noninvasive multi-energy therapy that shows promise as a simpler treatment for capsular contraction. Not only is it usually pain-free, it does not increase the risk of developing capsular contraction in the future. 

During treatment, your practitioner runs a special device over your breast without making any incisions. The device delivers controlled ultrasound waves to the tissue, which stimulates the growth of healthy collagen, making breasts feel soft and natural again. 

While still somewhat new, Aspen Therapy has been shown to be effective at treating Grade 2 and Grade 3 cases of capsular contraction. Grade 4 capsular contraction usually still requires surgery. 

Can Capsular Contracture Be Prevented? 

It is impossible to eliminate the risk of capsular contraction. If you do have certain risk factors, you may want to explore alternatives to breast implants such as fat grafting. 

There are other possible means to reduce your risk, including: 

  • Using the correct size implant based on your body type and amount of natural breast tissue 
  • Minimal implant handling by medical staff prior to insertion 
  • Getting implants placed under the chest muscles rather than over the muscles 
  • Gently massaging your breasts as they heal from augmentation

A reputable, board-certified plastic surgeon should work with you to find the right size implant, prioritize safe placement, and minimize implant handling prior to insertion. Working with a qualified surgeon should therefore greatly reduce your risk of capsular contraction. 

Capsular Contracture: The Bottom Line 

While capsular contraction can occur in anyone who receives breast implants, it remains a rare phenomenon with many different treatment options. While it can be an uncomfortable and often disheartening complication, a qualified medical team can successfully address the issue. 

Seeking treatment for capsular contraction? Leif Rogers is an Ivy League-educated, board-certified plastic surgeon and a standing member of the American Society of Plastic Surgeons. Get in touch with his team to schedule a consultation. 

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