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Capsular Contraction After Breast Augmentation: What, Why, And How

Do you ever feel that your body has a mind of its own? That is to say, just because you have come to the deeply personal, well thought out decision to get breast implants, your body don’t necessarily look the other way. Everybody -- no exceptions -- will initially react to a breast augmentation the same way: form a tissue lining around the implant. Our bodies treat breast implants as intruders, something to be walled off from the rest of the body. This reaction is completely normal and more often than not, you’ll never be the wiser. Sometimes, however, that lining the body forms around the implant will tighten over time causing physical discomfort and cosmetic changes in the appearance of the breast. This is not normal and is known as “capsular contraction.”

While the healing process after a breast augmentation procedure always involves the forming of scar tissue, most patients don’t develop capsular contraction. Most clinical reports site the incidence as less then 10%. But for those that do, it is simply the body tightening the capsule that has naturally formed around the implant. If the capsule tightens enough, the implant will get squeezed and become firm, harder to the touch and the breast contour can be visually changed. Even if this occurs, it’s still worth remembering that the implant itself is not hardening. It feels hardened because of the body’s squeezing of it, but if the implant is removed it will be just as soft to the touch as the day it was inserted.

So, why does capsular contraction happen to some patients and not others? There’s no concrete answer. There are generally accepted risk factors that are associated with higher incidence of capsular contraction. Among them: contamination of the implant, a hematoma, placement of the implant above the muscle and smoking. Each of these factors can be addressed before the breast augmentation procedure. Obviously your surgeon will be making every effort to avoid contamination and hematoma during your procedure. Many cosmetic surgeons, including the cosmetic surgeons here at GLOW, use a triple antibiotic flush during the procedure which has been shown to dramatically reduce the incidence of capsular contraction. The choice of placement is one you and your surgeon will make together based on your cosmetic goals. Finally, quitting smoking several weeks before your procedure is something you can do for yourself to both reduce your chance of capsular contraction and improve your overall health.

After surgery there are some actions you can take that may reduce the chances of you developing capsular contraction including wearing a compression bra and performing massage as instructed by your cosmetic surgeon. Now, even if you do everything right -- you quit smoking before the surgery, you follow your surgeons instructions, wear your compression bra faithfully and massage -- it's still possible you'll have to deal with capsular contraction. There are numerous ways to treat the complication. Which treatment makes the most sense will depend on how the tightening of your body's capsule is affecting your implants and your comfort level. There are four grades of capsular contracture (the Baker scale) with Grade IV being the most severe and featuring the breast implant being hard to the touch and perhaps distorted in a appearance. Massage, ultrasound and medications are sometimes enough to make the stiff capsule relax. Or, additional surgery might be necessary to loosen the scar tissue around the implant or remove the stiffened capsule entirely. In this scenario, your cosmetic surgeon would work with you to determine the best solution for your body and implants.

Capsular contraction is unusual but should it happen to you, it can seem quite common. The fact is our bodies will treat any foreign object, breast implants included, the same way, and that is to surround the object with a capsule of fibrous scar tissue. This is a normal, natural, occurrence. Only when that tissue overly tightens around the breast implant does capsular contraction become something to address. And even in the worst case scenario, it’s easily treatable and it is something your GLOW cosmetic surgeon will help you through every step of the way. The end result and goal of a breast augmentation remains unchanged: helping you achieve the self-image you want and deserve.

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