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Capsular Contracture and Repair Using Breast Revision Surgery

Scar tissue forms over any foreign implant placed inside the body. After a patient gets breast implants, a fine layer of scar tissue forms over each implant and builds with time. This scar tissue layer is known as a breast capsule.

Formation of scar tissue is the body’s normal way of identifying a foreign object when inserted, and it is an important part of healing. In some patients, scarring triggers several immune system reactions. In response, scar tissue begins to thicken around the implant – a process called implant encapsulation.

The severity of encapsulation ranges from mild, characterized by no external visible signs of distress, to extreme, which requires surgical correction. Extreme encapsulation is an issue known as capsular contracture. Breast revision surgery can be used to correct this issue.

Signs of Capsular Contracture

Capsular contracture can be diagnosed during a consultation with a plastic surgeon. A plastic surgeon easily notices even minute signs of capsular contracture, along with well-defined signs like hardening of the implant and distortion in shape. Some may even experience a sensation of constriction or feeling heavy-chested when the capsule starts to tighten.

Progression of capsular contracture is graded on a scale of I-IV:

  • Grade I: The breast appears normal and is soft to the touch.
  • Grade II: The implant feels disjoined and there is slight but noticeable hardening of the breast.
  • Grade III: There is a prominent distortion in the shape of the implant, and the breast feels firm.
  • Grade IV: There is severe pain, tenderness, and hardening in the breast, emphasized by a severe distortion in shape.

In a few cases, the affirmation of capsular contracture is done through a mammogram, MRI, or ultrasound.

Correction of Capsular Contracture Through Breast Revision Surgery

There are many corrective measures to remove thickened scar tissue and signs of capsular contracture. The corrective procedure used for your capsular contracture will depend on your specific issue. Corrective procedures include:

  • Capsulotomy: A fine incision is made in the scar tissue capsule. This method is effective not only when the capsule must be removed but also when the pocket of the implant must be re-centered.
  • Capsulectomy: Surgical removal of the scar tissue capsule is known as capsulectomy. This is the most effective method of capsule correction. The implant is either moved to a sub-muscular position or switched with another textured implant. This procedure does not eliminate the probability of the reoccurrence of capsulation but is the most effective method for limiting the recurrence.
  • Capsulectomy with Dermal Matrix: The procedure is similar to capsulectomy, but a different implant swathed in acellular dermal matrix is placed in the breast pocket.

The replacement with a different implant is believed to be the best option currently available. Formation of scar tissue or capsulation is known to be triggered by bacterial contamination, and it is recommended that the source be removed to limit repeat infection.

Consult with Your Plastic Surgeon

If your breast implants are feeling tighter and are looking distorted, you may be experiencing capsular contracture. Arrange a breast revision consultation by contacting the office of Dr. Kenneth Hughes, a board-certified plastic surgeon.