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Breast Implant Revision for Capsular Contracture

Posted Oct 16, 2013 by Stephen Greenberg, MD

Manhattan Capsular ContractureUnfortunately, even the most skilled plastic surgeon can't predict how each patient will heal. After breast augmentation, unpredictable healing patterns can affect the final result and leave you feeling uncomfortable or even dissatisfied with your new appearance. Some women opt to undergo a secondary surgery, either to change the implant size or to improve the look or feel of the implants. Of all the various reasons, one of the most common reason is to correct a problem known as capsular contracture. If you are considering breast implant revision to correct capsular contracture in the Manhattan area, here's what you should know about the surgery.

What Is Capsular Contracture?

When a breast implant is inserted, the body reacts by forming a protective lining around it. The body uses blood vessels, collagen, and fibroblasts to "wall off" the foreign object as a defense mechanism. The process is normal for all kinds of implants - smooth or textured, silicone or saline.

In a small percentage of patients, this capsule begins to squeeze or contract upon itself, usually noticeable within six weeks of surgery. The contracture can be due to an infection or a hematoma (blood) around the implant, but in most cases, the cause is unknown.

Although the implant itself remains soft inside, the contracted tissue squeezes the implant, which makes the breast feel hard. There are four different stages of this complication (defined by a plastic surgeon named Baker):

  • Baker grade I means the breast looks and feels soft.
  • Baker grade II means the breast looks normal but feels a little firm.
  • Baker grade III means the breast feels firm and looks somewhat distorted (like a round ball instead of a teardrop shape) or is being squeezed out of normal position (usually upward).
  • Baker grade IV is the same as III but with the addition of pain.

It's worth noting that capsular contracture alone does not cause implant rupture.

How Is Capsular Contracture Fixed?

A small percentage of women with implants develop capsular contracture severe enough to require surgery. Surgical treatment involves either cutting the capsule to release its hold on the implant (capsulotomy) or by removing the entire capsule (capsulectomy). If the entire capsule is removed, the body will form a new capsule, but this procedure has a higher rate of success than simply cutting the capsule. Rarely, a patient will experience repeated capsular contracture; the majority of cases can be successfully treated.

Additionally, breast implants placed under the muscle tend to have a decreased rate of capsular contracture. Although not necessary, some patients who had implants placed above the muscle (subglandular) and undergo a secondary surgery to repair capsular contracture will also opt to have the implants reinserted under the muscle. This results in tremendous improvement in the shape and contour of the breasts.

Learn More about Breast Implant Revision

Nationally renowned plastic surgeon Stephen T. Greenberg, M.D., achieves the most natural results with breast augmentation by individualizing the procedure to each patient's body, breast type, and breast shape. If you would like more information about capsular contracture, or if you are otherwise unhappy with the results of your prior breast augmentation, we encourage you to schedule a consultation with Dr. Greenberg.

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