Capsular contracture is when breast tissue hardens around a newly inserted implant and distorts the breast’s appearance. This hardening happens because the tissue is responding to the foreign implant, and attempting to seal it off. Capsular contracture is the most common negative side effect following breast augmentation. It can affect one or both breasts and oftentimes leaves women regretting their decision to undergo a breast augmentation at all. So, what can be done?
Dr. Kimberly Short understands how difficult capsular contracture can be and how any next steps might feel uncertain or promising. Throughout her career, Dr. Short has helped hundreds of women overcome capsular contractures and achieve the breasts they wanted in the first place. During either a revision or a removal surgery, Dr. Short can correct the hardening tissue and replace the implant with a more natural orientation on the chest. She then takes the steps many other surgeons don’t. Dr. Short implements many different safeguards in your surgical procedure to help avoid a future capsular contracture.
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What Is Capsular Contracture?
Over the last few decades, as technology and approaches have improved, breast enhancement procedures have become the most popular in the plastic surgery industry. Specifically, breast augmentation was performed around 290,000 times in 2019, making up 11% of the year’s plastic surgery procedures. During a breast augmentation, a surgeon makes a strategic incision to place a gel implant under the breast tissue. These implants are carefully designed to meet the patient’s desired alterations and provide natural-looking results. After the augmentation surgery, a capsule of scar tissue forms around the implant. This is a natural part of the healing process. During any surgery where non-biological material is introduced, the body induces the formation of a capsule. In the breast, however, it can be particularly severe.
While the exact cause of capsular contracture is disputed, many believe that the body’s inflammation response plays a heavy role. When the body forms the capsules around the implants, it boosts collagen production in the breast tissue. For most women, this collagen production stops after a few weeks once the body has accepted the implants. Their breasts rest naturally even, achieving their desired results. But, in cases of capsular contracture, the tissue responds with an inflammatory reaction that causes an excessive amount of connective tissue to grow. This connective tissue is oftentimes painful when touched and displaces one or both implants to rest awkwardly on the patient’s chest. For most, this unevenness becomes too noticeable for comfort. Luckily, there are surgical solutions that correct capsular contracture and achieve the patient’s longed-for frame.
How Common Is A Capsular Contracture?
If you have experienced a capsular contracture, you are not alone – far from it, unfortunately. While the exact number varies, the overall incidence rate of capsular contracture is between 3% and 19%. That means between 8,700 and 37,700 women experienced capsular contracture following a breast augmentation in 2019.
Degrees of Contracture
While your specific circumstances are unique, there are five different degrees of capsular contracture. Knowing which one your circumstance are closest to will help in deciding if you need a revision procedure.
- Grade I: Lowest on the scale are the intended results. Grade I describes when the breast has the right texture, appears normal, and achieves the desired outcome. Patients are satisfied with the look and feel of their new breasts.
- Grade II: In Grade II, the tissue is slightly firm but does not alter the breasts’ appearance. This firmness is the result of minor scar tissue growth, which (again) does not cause any aesthetic issues.
- Grade III: Grade III is where issues may arise. Here, the breast tissue is firmer and may have displaced the implant or negatively altered its shape. For some, Grade III does not inhibit the patient’s happiness with her breasts.
- Grade IV: Patients who have breasts that are hard to squeeze and painful to touch are in Grade IV. The implant has shifted locations and appears abnormal in shape. This shift, unfortunately, can often be seen through clothes.
About Implant Revision or Removal
So, if you are experiencing a capsular contracture following breast augmentation, what are your options? After meeting with a board-certified plastic surgeon, you might choose an implant revision. These surgical procedures require specific precautions and after-care that are similar to your initial augmentation. Typically, Dr. Short likes to use the same incision points as the previous surgeon so that there is no additional scarring. Once inside the breast pocket, she removes the implant and focuses on the overgrowth of scar tissue. Depending on your condition, Dr. Short may cut away the scar tissue and remake a better pocket or shift the placement of the implant entirely. Other placements include:
- Under the breast tissue
- Under the muscle
- A combination of under the skin and under the muscle
While all three placements occasionally result in capsular contracture, implants placed under the muscle have a lower incidence rate. Once Dr. Short achieves your desired results, the ones you hoped for from your initial procedure, she will close the incision points and wrap your chest in a compression bandage.
Is A Revision Right For Me?
The real question isn’t, “Is a revision right for me?” Rather, ask yourself, “Am I satisfied with the results of my breast augmentation?” The goal of the initial surgery was to give you more confidence in yourself, not less. If your desired results were not achieved, then you shouldn’t have to live with unsatisfactory results. Dr. Short is committed to helping women achieve their ideal image of femininity, whatever that may look like. A breast implant revision is ideal for patients whose breasts are painful to touch or rest awkwardly on their chest. These effects typically steal patients’ ability to enjoy various activities in daily life.
So, what’s the first step? If you believe you have capsular contracture, schedule a consultation with us. Here, Dr. Short will diagnose your contracture and recommend if a revision is necessary. For some who don’t have a contracture, they want to change the size or shape of their implants. A breast revision is ideal for these patients as well.
In the past couple of years, we have started taking a majority of our initial consultations online. During these consultations, we will ask about your recent medical history, your initial augmentation, and your desired results. Then, we will inspect the degree of your condition and rate the contracture based on the Baker Scale. Dr. Short will examine implants and note if new ones are needed or if the existing ones can achieve the intended results. She will note your previous surgeon’s approach and determine what the best approach is for her. At the end of your consultation, she will finalize a personalized treatment plan. This will include any changes and any specific instructions regarding your pre- or post-operative care.
Before A Revision
The best way to prepare for your revision surgery is to mirror the steps you took before your initial augmentation. There may be additional steps for your unique circumstances, but generally, we recommend that you:
- Discontinue taking any blood thinning medications or supplements. If you are prescribed a blood thinner, talk with your healthcare provider before doing so.
- Avoid alcohol leading up to your revision. Alcohol can cause excessive bruising in the treated areas.
- Avoid nicotine a couple of weeks before. Nicotine interferes with your body’s healing response and causes unwanted effects.
- Pre-fill prescriptions before the date of your surgery.
- Designate a caregiver to drive you home.
This recovery phase may be a little easier than the one after your augmentation because you know what to expect. We recommend taking the next couple of days off from work to focus on rest and recovery. Also, please plan not to lift any heavy objects or partake in any strenuous activities. These can cause the sutures to break and cause adverse effects. We will give you more personal instructions during your consultation and follow-up appointments.
How Much Does A Breast Implant Revision Cost in Indianapolis?
During our initial meetings, we will discuss the price and the cost of your procedure. We will need to factor in surgical requirements and any implant upgrades you may request. If you would like to learn about our financing options, visit our financing page to learn about our options. For those who enjoyed reading this blog post, check out our others! To reach us directly, call us at:
- 2019 Plastic Surgery Statistics. (2019). American Society of Plastic Surgeons. https://www.plasticsurgery.org/news/plastic-surgery-statistics?sub=2019+Plastic+Surgery+Statistics
- Headon, H., Kasem, A., & Mokbel, K. (2015). Capsular Contracture after Breast Augmentation: An Update for Clinical Practice. Archives of plastic surgery, 42(5), 532–543. https://doi.org/10.5999/aps.2015.42.5.532
- Hidalgo, David A. M.D.; Weinstein, Andrew L. M.D., M.S. Surgical Treatment for Capsular Contracture: A New Paradigm and Algorithm, Plastic and Reconstructive Surgery: September 2020 – Volume 146 – Issue 3 – p 516-525 doi: 10.1097/PRS.0000000000007079