While it is rare to experience complications after breast augmentation, they do occur on occasion. One of the most common difficulties women encounter is capsular contracture, which is a buildup of scar tissue that can lead to disfigurement and discomfort. Fortunately, there are effective ways to remove the scar tissue to restore the appearance of the breast and eliminate uncomfortable symptoms that often accompany this condition.
From Dr. Barrett
“Capsular contracture is a breast surgeon’s most frequent enemy. It occurs nationwide in approximately one in every 20 patients. It is a complication that I encounter with my own patients at a much lower rate because of the techniques I use during the implant process, but It is something we are constantly looking for new ways to prevent. When we do have a patient with capsular contracture, I don’t like to wait around. If they have failed conservative measures such as aggressive massage and medical treatment with singulair, surgical correction becomes the next step. Capsular contracture should not be something anyone should live with and I cringe when I hear of women enduring the condition for more than a few months. Breasts should be natural and supple, and women should be happy when they look in the mirror. Fixing capsular contracture requires an aggressive approach to reduce the risk of recurrence. Many surgeons cut corners on the corrective surgery but there are many steps that need to be done to reduce the risk of recurrence. The implants need to be replaced completely. The scar tissue needs to come out completely. Irrigation must be performed. The patient needs to be on medical therapy throughout the process and for six months after. Anything less reduces the chance for success.”
Capsular contracture may occur at any time, but Dr. Barrett usually sees patients that fall into one of two categories. The first is early capsular contracture, which surgeons believe results from factors related to surgery such as bacteria introduced when the implants are placed or disruption in the body’s initial healing processes. Late-stage capsular contracture is usually caused by implant ruptures or negative response by the immune system if it mistakes the implant for a foreign body and a health hazard. Dr. Barrett has experience treating both of these types of capsular contracture and will help you tailor a treatment program to eliminate the complication and produce the best possible outcome for you.
BEFORE AND AFTER PHOTOS
Case #29041
Female, 20 yo, Caucasian
Bilateral implant revision
Bilateral capsulectomy
Bilateral neosubmuscular pocket creation
Removal of old implants
Placement of new mentor moderate profile plus textured round silicone implants
Case #64891
Removal and replacement of breast implants with pocket repair
Bilateral Explanted Implants:
Allergan Moderate Profile Silicone
Right: 457cc
Left: 397cc
Bilateral Mentor Moderate Profile Plus Smooth Silicone Implants
Right Size: 300cc
Left Size: 275cc
Case #37691
Capsulectomy (Right Side Only); Remove and Replace with Silicone Implant
What is Capsular Contracture?
After surgery, scar tissue will form around the implanted materials as a natural part of the healing process. While some scarring is typical, there are cases when the scar tissue will tighten around a breast implant, creating a capsule covering that is abnormally firm, unnatural or even painful. This tightening is the condition known as capsular contracture and the most common reason why some implant surgeries lead to noticeably round, hard breasts or “coconut breasts.”
The FDA has identified four different grades, which are known as the Baker Scale of Capsular Contracture:
- Grade 1: Breast both looks and feels soft and normal
- Grade 2: Appearance is normal, but there is slight firmness to the breast
- Grade 3: There are noticeable distortion and firmness to the breast
- Grade 4: Breast becomes more distorted, hard and tender
Approximately three-fourths of all incidences of capsular contracture will occur within two years. However, that does not mean the condition cannot develop later. If you experience any changes or symptoms to your breasts after breast augmentation surgery, it is always best to schedule an examination with a plastic surgeon experienced in breast enhancement complications.
Is Capsular Contracture Removal Right for Me?
Women are usually good candidates for capsular contracture removal if they suffer any one or a combination of the following symptoms:
- Breasts that feel hard to the touch
- Breasts that appear distorted, rounded of off-centered
- Feelings of discomfort around the implant area
- Implant rupture, which may or may not be visible on the outside of the breast
Choosing Your Plastic Surgeon
When you experience complications after your breast augmentation, it can be distressing to think about undergoing additional surgery to address the problem. For this reason, it is vital that you choose a surgeon for your procedure that has not only the experience but also the compassion to handle your situation with the utmost care and attention. Dr. Barrett is known for taking ample time with each patient to ensure he understands their concerns and goals. By the same token, his experience and expertise in breast revision techniques offer the valuable insight that will produce your best possible outcome.
Options in Capsular Contracture Removal
Dr. Barrett uses three different methods to treat capsular contracture:
- He can perform a closed capsulotomy, in which he applies firm manual compression to the outside of the breast to break of the scar tissue inside. This method does not require incisions or a new implant, making it the least invasive of all the treatment options.
- He may recommend an open capsulectomy, which removes the scar tissue from around the implant. This technique requires an incision within the breast area to excise the scarring. If necessary, he will also switch out the old breast implant for a new one.
- Dr. Barrett also offers an in-continuity or en bloc removal, which removes the implant and the scar tissue at the same time in a single unit. This method is commonly used when tissue buildup is caused by bacteria (such as Staphylococcus epidemidis or staph epi) or a silicone implant rupture.
Please schedule a consultation with Dr. Barrett to ensure that you make the best choice given your situation.
Procedure Overview
Dr. Barrett may perform your capsular contracture removal under general anesthesia or local anesthesia with sedation. He will place your incisions in the natural folds of the skin whenever possible to minimize visible scarring afterward. Through the incisions, Dr. Barrett removes then capsule and the implant when appropriate, closing the incisions with a layered approach that eases tension on the area and creates better healing of the opening. Capsular contracture removal varies regarding time, depending on how extensive the procedure needs to be to achieve the best results.
After Capsular Contracture Removal
Patients should plan for at least two weeks to recover from a capsular contracture removal, as there will be mild pain, swelling, temporary numbness and bruising around the chest region. Bruising will resolve within the second week, although swelling will likely take a bit longer to subside. There is a significant improvement for most patients after about one week to 10 days, but you may need to wait a bit longer to resume all your regular activities to give the surgical site enough time for healing.
Dr. Barrett meets with all his patients once a week for six weeks after surgery. During the first two appointments, your layers of sutures will be removed and replaced with tape. After the taping period is over, Dr. Barrett will prescribe a silicone scar get that enhances the healing process. You will apply this patented solution to your incision twice a day for three months. It is also essential to keep the incision out of direct sunlight during the early months to avoid complications in the healing process. Dr. Barrett will give you specific instructions on how to best care for yourself during your recovery period that is
Restoring Health and Beauty to the Breasts
It can be frustrating for a woman to go through the breast augmentation process, only to develop complications like capsular contracture after the fact. Fortunately, Dr. Barrett’s experience and expertise offer women an effective way to reverse this condition and restore the natural beauty of the breasts. To get an assessment or find out if capsular contracture is right for you. Contact Barrett Plastic Surgery today at 310-598-2648.
The information about removal of capsule contracture was reviewed by Dr. Daniel Barrett. If you have any questions, please don’t hesitate to contact us using our contact form below.