Capsular contracture is a complication that can occur after breast augmentation surgery. It involves the formation of scar tissue around the breast implant, which can cause the breast to feel firm or tight. This condition can be uncomfortable and may even change the shape or appearance of the breast. In this article, we will explore the various factors that can contribute to the development of capsular contracture.
1. Implant Placement
The position of the breast implant plays a crucial role in the occurrence of capsular contracture. When the implant is placed above the chest muscle (subglandular placement), there is a higher risk of developing scar tissue. This is because the implant is in direct contact with the breast tissue, leading to increased friction and irritation.
In contrast, submuscular placement, where the implant is positioned beneath the chest muscle, can reduce the risk of capsular contracture. The muscle provides an additional layer of protection and cushions the implant, minimizing the chances of excessive scar tissue formation.
It is important to discuss the pros and cons of these different placement options with your surgeon to make an informed decision before undergoing breast augmentation surgery.
2. Implant Texture
The texture of breast implants can influence the incidence of capsular contracture. There are two main types of implants: smooth and textured. Smooth implants have a higher risk of developing scar tissue compared to textured implants.
Textured implants have a slightly rough surface, which helps to disrupt the capsule formation process. This textured surface encourages the growth of collagen fibers, which can prevent the capsule from becoming too tight or constrictive. However, it is essential to note that textured implants have been associated with other complications, such as an increased risk of a rare form of lymphoma. Consulting with your surgeon is crucial when choosing the type of implant that is best suited for you.
3. Bacterial Contamination
Infections can lead to capsular contracture. Bacterial contamination during surgery or within the implant pocket can trigger an inflammatory response, causing the formation of excessive scar tissue. This emphasizes the importance of maintaining strict sterility during the surgical procedure and following post-operative care instructions diligently.
In cases where infection occurs, prompt medical attention and appropriate antibiotic treatment are necessary to minimize the risk of capsular contracture.
4. Hematoma
A hematoma is a collection of blood that can occur post-surgery due to bleeding in the implant pocket. Hematomas can create an inflammatory environment, leading to an increased risk of capsular contracture. To reduce this risk, surgeons typically use drains to remove excess blood and fluid from the surgical site during the immediate post-operative period.
5. Trauma to the Implant
Excessive trauma or injury to the breast can disrupt the healing process and contribute to the development of capsular contracture. This can occur due to accidents or impacts to the breast area. It is crucial to be cautious and protect the breasts from any potential trauma, especially during the initial stages of recovery following breast augmentation surgery.
6. Smoking
Smoking has been identified as a significant risk factor for capsular contracture. Cigarette smoke contains harmful chemicals that can impair the healing process by reducing blood flow and oxygen supply to tissues. This impaired blood circulation can lead to a higher risk of complications, including the development of capsular contracture.
To minimize the risk, it is essential to refrain from smoking or using any tobacco-related products before and after surgery.
7. Genetic Predisposition
Some individuals may have a higher genetic predisposition to developing capsular contracture. Genetic factors can influence the way our body responds to foreign substances, such as breast implants, and how scar tissue forms. If you have a family history of capsular contracture, it is important to discuss this with your surgeon during the pre-operative consultation.
8. Post-Operative Care
Proper post-operative care and adherence to instructions provided by your surgeon can significantly reduce the risk of developing capsular contracture. This includes regular follow-up visits, massaging techniques, and wearing appropriate support garments.
FAQs (Frequently Asked Questions)
Q: Is capsular contracture a common complication?
A: Capsular contracture occurs in a small percentage of breast augmentation patients. However, the risk can be further reduced by considering various factors, such as implant placement, texture, and following post-operative care instructions.
Q: Can capsular contracture be treated without surgery?
A: Mild cases of capsular contracture can sometimes be treated with non-surgical methods, such as implant massage, medications, or ultrasound therapy. However, in more severe cases, surgical intervention may be necessary to address the issue.
Q: Can capsular contracture recur after treatment?
A: Although treatment may successfully reduce the severity of capsular contracture, there is always a slight possibility of recurrence. Close monitoring and adherence to post-operative care instructions can help minimize this risk.
References
1. Adams, W. P. (2012). Capsular contracture: what is it? What causes it? How can it be prevented and managed? Clinics in Plastic Surgery, 39(3), 261-270. doi: 10.1016/j.cps.2012.05.001
2. Wong, C. H., Samuel, M., & Tan, B. K. (2007). Capsular contracture in subglandular breast augmentation with textured versus smooth breast implants: a systematic review. Plastic and Reconstructive Surgery, 119(4), 1259-1266. doi: 10.1097/01.prs.0000254416.22040.5a
3. Headon, H., & Kasem, A. (2016). The association between risk of implant-related complications and breast implant selection. Archives of Plastic Surgery, 43(4), 328-339. doi: 10.5999/aps.2016.43.4.328
