Capsular contracture is a term that often comes up in conversations about the possible complications of breast implants.
If you’re thinking about getting breast implants with a breast augmentation procedure, it’s important that you understand what capsular contracture is, how it develops, and how it can be addressed.
This blog will outline all of the important details of capsular contracture, including how it forms, the grades it’s classified into, and what to expect should it occur and need treating.
What is capsular contracture?
As part of the healing process after breast implant surgery, your body will naturally form a capsule of scar tissue around each implant.
This actually happens for every patient, as it’s the body’s standard way of protecting itself from what it identifies as a foreign object. Most of the time, the scar capsule is thin and soft, and it doesn’t interfere with the breast implant itself.
In other cases, however, capsular contracture may occur. Capsular contracture is when that scar capsule becomes abnormally tight or thickened. It starts to squeeze the implant, which can cause it to feel firm or move out of its original position. Sometimes, this tightening can cause discomfort, while it might not be painful at all for other patients.
When is capsular contracture likely to occur?
Essentially, capsular contracture can occur at any point after breast implant surgery.
Sometimes it can occur as early as a few months in, but it can also occur years later. It’s not entirely clear why it occurs in some cases and not in others, but multiple factors have been linked to an increased risk.
If a haematoma (collection of blood) or infection occurs around the time of surgery, this can trigger a more significant response from the body, which may lead to capsular contracture.
Other possible triggers include the implant’s placement (whether it sits above or below the muscle), the texture of the implant, and any trauma that may have been caused to the breast area after the surgery.
How capsular contracture is graded
Capsular contracture is classified into four grades, known as Baker grades. The grading system essentially helps to assess how much the capsule is affecting the breast and implant.
In grade I, the breast tends to look and feel normal, without noticeable firmness or distortion. Grade II means the breast still looks normal, but can feel slightly firm to the touch. By grade III, the breast is firm and has started to look different – the implant might appear higher on the chest wall, or the shape could appear more rounded. Grade IV is the most advanced, where the breast feels hard, looks distorted, and might even be causing discomfort.
It’s possible for some patients to remain at grade II for years without needing any further intervention. However, once it reaches grade III or IV, revision surgery is often considered.
What to look out for: Signs that capsular contracture has occurred after your breast augmentation procedure
One of the first things that can indicate the development of capsular contracture is a change in the way the breast feels.
Essentially, it might start to feel firmer than it did in the months after surgery, or it might sit higher on the chest or look slightly distorted.
Sometimes, patients notice that the breast has become rounder in shape, or that the two implants no longer look symmetrical. In the more severe cases, there can be noticeable tightness, and the implant may feel like it’s being pulled upwards. While not always painful, the sensation of tightness can become uncomfortable, especially if there’s pressure when lying on your stomach or during exercise or certain movements.
How is capsular contracture treated?
If the capsular contracture is at a level where surgery may be necessary, the most common treatment approach would be a capsulectomy.
During a capsulectomy, the entire capsule of scar tissue is removed. In some cases, a capsulotomy might be performed instead, which involves cutting the scar tissue to release the tightness, rather than taking out the capsule completely.
These procedures can be performed with or without replacing the breast implants with new implants – essentially, it will depend on factors like the extent of the contracture and the patient’s personal preferences.
If you do choose to have the implants replaced, your doctor might change the implant type or its position to help lower the risk of recurrence.
What to expect if you need surgery to treat capsular contracture
Surgery to treat capsular contracture is usually a little more extensive than a standard breast implant replacement procedure.
This is because the capsule tissue is often thickened or attached to surrounding muscle or skin, which means it can take more time to carefully remove it.
Swelling, bruising and temporary changes in sensation can occur in the early stages of recovery, and you’ll likely need to take time off from exercise and heavy lifting. It’s also possible that your doctor will recommend having a different breast implant type or placement to help prevent the issue from occurring again, but it will entirely depend on your individual situation and needs.
Since it is still a surgical procedure, you can expect to have a preparation and recovery period, with careful steps to follow to care for your body and prevent any post-surgical complications. You’ll be able to discuss all of these factors during your consultation.
See Dr Rastogi in Double Bay, Sydney
It is important to learn about what may occur after a breast augmentation procedure if you are considering receiving breast implants.
Some complications, like capsular contracture, may be quite simple to treat. It’s still essential to familiarise yourself with how breast implants may behave in the body, signs to look out for and the details of possible future procedures.
During your consultation with cosmetic doctor Dr Rastogi, you can discuss your surgery plan and the important details of possible complications, including capsular contracture.
Please feel free to enquire with our team if you have any questions or would like to book a consultation with Dr Rastogi in Double Bay, Sydney.
