Capsular Contracture
Capsular contracture is the abnormal formation of scar tissue around a breast implant, which can distort the shape of the breast and cause physical discomfort. This condition affects around 10 percent of women who undergo breast augmentation or breast reconstruction. In the hands of an expert cosmetic surgeon like Dr. Stephen T. Greenberg, capsular contracture can be corrected, and a beautiful bustline can be restored.
If you have experienced capsular contracture, you can restore both the appearance of your breasts and your physical comfort by undergoing treatment for the condition at Greenberg Cosmetic Surgery and Dermatology. The expert surgeons at our offices serving Southampton, Smithtown, Woodbury, Scarsdale, New York City, Princeton, and Boca Raton can help you enjoy the results of your breast augmentation once again.
At Greenberg Cosmetic Surgery and Dermatology, we prioritize patient safety and satisfaction above all else. Double board-certified Stephen T. Greenberg, MD, FACS; Jason M. Weissler, MD, FACS; Stephanie A. Cooper, MD; and Jacqueline Ross, MD, are dedicated to providing you with a comfortable and positive experience from start to finish. If you are ready to explore your options for treating capsular contracture, contact us at (888) 680-2090 to schedule your consultation with us at our New York City location in Manhattan, our office in Scarsdale, or one of our offices on Long Island: Southampton, Smithtown, or Woodbury, as well as Princeton and Boca Raton.
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What Is Capsular Contracture?
Capsular contracture is the most common complication that can occur after breast augmentation or reconstruction. Scar tissue naturally forms around your breast implants following breast augmentation surgery, helping to contain the implant within the breast pocket. While the formation of a thin, flexible capsule of scar tissue is expected during the healing process, capsular contracture occurs when the capsule thickens and constricts the breast implant, leading to hard, painful, or misshapen breasts.
Capsular contracture can develop months or even years after surgery and may affect one or both breasts. In more advanced cases, it can cause significant discomfort and dissatisfaction with your cosmetic results, making surgical treatment necessary.
What Causes Capsular Contracture?
Unfortunately, it is not entirely clear what causes some women to develop capsular contracture. However, several factors are known to increase the risk, including:
Low-grade Bacterial Contamination (Biofilm)
Even tiny amounts of bacteria on the surface of your breast implant can trigger chronic, low-level inflammation, which can cause the capsule to thicken and tighten over time.
Hematomas or Seromas
Collections of blood or fluid around the implant (known as seromas or hematomas) can interfere with routine healing. If not resolved quickly, they may promote excessive scar tissue formation and capsule contraction.
Implant Failure
When an implant (especially an older silicone model) leaks or ruptures, the surrounding tissue can become irritated and trigger a strong inflammatory response that can harden the capsule.
Subglandular Implant Placement
Breast implants may be placed either above or below the pectoral muscle. Capsular contracture tends to occur more frequently among women who have opted for subglandular placement, which places the breast implant above the pectoral muscle but below the breast tissue.
Smoking
Nicotine restricts blood flow and oxygen to healing tissues, increasing the risk of abnormal scarring and making the capsule around your implant more likely to contract during recovery.
Autoimmune Response
Patients with heightened immune or inflammatory responses may naturally form thicker, firmer scar tissue, making them more susceptible to developing capsular contracture.
Signs of Capsular Contracture
Symptoms of capsular contracture typically develop gradually and may include:
- Increasing breast firmness or a feeling of tightness around the implant
- Visible changes in breast shape, such as a rounder or unnaturally elevated appearance
- Pain or tenderness, especially as the capsule becomes more rigid
- Noticeable asymmetry, where one breast sits higher or feels harder than the other
- Reduced implant mobility or a “ball-like” feel when touching the breast
Stages of Capsular Contracture
Capsular contracture is categorized using the Baker classification system:
Grade I: Your breast looks and feels soft and natural.
Grade II: Your breast looks normal but feels slightly firm.
Grade III: Your breast is visibly distorted and feels firm to the touch.
Grade IV: Your breast is hard, painful, and clearly misshapen.
Grades III and IV usually require surgical treatment, while early stages may be monitored or addressed with non-surgical methods.
Treatment Options for Capsular Contracture
Treatment for capsular contracture depends on the severity of the condition and the degree of breast distortion or discomfort you are experiencing. While early stages of the condition may sometimes be managed with massage or anti-inflammatory medications, moderate to severe capsular contracture typically requires surgical intervention via breast revision. The three primary surgical approaches to addressing the condition include capsulotomy, capsulectomy, and en bloc capsulectomy.
Capsulotomy
A capsulotomy involves releasing or cutting the constrictive scar tissue capsule to create more space for the breast implant. Instead of removing the capsule, your surgeon makes precise incisions inside the capsule to soften it and help return your implant to a more natural position. This method can be effective for patients with mild to moderate capsular contracture who want to keep their current implants. Recovery is often shorter than with more extensive capsular contracture treatments; however, capsulotomy is not always appropriate for severe or recurrent cases.
Capsulectomy
A capsulectomy is performed to remove all or part of the scar tissue surrounding the affected implant. Depending on your needs, you may undergo a partial capsulectomy, which targets only the thickened areas of scar tissue, or a total capsulectomy, which removes the entire capsule. Capsulectomy is often recommended for patients with more severe capsular contracture, as it provides a more thorough solution than capsulotomy. By eliminating the problematic scar tissue, your surgeon can create a healthier environment for a new implant. Capsulectomy offers a reliable long-term solution but requires more recovery time due to more extensive tissue manipulation.
En Bloc Capsulectomy
An en bloc capsulectomy removes the implant and capsule together as a single intact unit. This technique is typically reserved for situations where the capsule must not be opened, such as when there is concern about implant rupture, silicone leakage, or significant inflammation.
Preventing Capsular Contracture
Again, as there is no concrete cause of capsular contracture, it may be impossible to prevent. Implant replacement, switching to a different type of implant, or placing the new implant in a different position (such as moving it from above to below the muscle) may improve your chances of avoiding a recurrence of capsular contracture and improving the appearance of your breasts. Some patients opt to remove their implants entirely. Advanced surgical techniques and implant technology help reduce recurrence and restore a more natural breast look and feel.
Contact
If you are experiencing capsular contracture or if you are considering breast augmentation or reconstruction, contact Greenberg Cosmetic Surgery and Dermatology today at (888) 680-2090. Dr. Greenberg has built an impeccable reputation upon his work in breast surgery, and he can help you achieve the life-changing bust line you deserve.
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