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Paul Durand, MD
Karl William Schwarz, MD

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Breast Revision to Address Capsular Contracture

Posted March 31, 2017 in Plastic Surgery

Capsular contracture is a common complication following breast augmentation. Breast revision techniques can correct this painful condition.

What Is Capsular Contracture?

When any foreign substance enters the body, the body’s natural defense systems recognize it as a threat and begin to attack. The implants used in breast augmentation are also seen as foreign objects, and the body begins to form fibrous scar tissue around it.

This scar-tissue shell is called a capsule. Capsules also form around other implants, such as orthopedic implants used for the knee and pacemakers used to correct heart problems.

Although the capsule itself is a very common occurrence in people who have implants, it can sometimes begin to harden and tighten. When this happens, it is called capsular contracture. It can result in pain, pressure, and infections.

The exact cause of capsular contracture is not known, but experts believe it could be due to bacterial growth and infection. Blood clots or leakage of the implant are other possible causes.

Capsular contracture has been classified into several grades based on the severity of symptoms. In Grade 1, the breast looks normal and is soft. In Grade II, although the breast looks normal, it may feel a little hard to the touch. In Grade III, not only is the breast hard, but the implant moves up on the chest, giving the breast a distorted appearance. In Grade IV, there is severe pain, discomfort and increased hardness.

What Is Breast Revision Surgery?

The corrective procedure to remove or alter the scar-tissue capsule is a form of breast revision. Two types of breast revision techniques are done, depending on the extent or grade of the capsular contracture:

• Open capsulotomy is done when there is no leakage or rupture of an implant that is placed above the chest muscle. A small incision is made under the breast or around the areola to remove the capsule that is pressing against the implant. After removing the necessary amount of capsule, the incision is sutured up.

• The second technique, called a capsulectomy, is used when the implants have ruptured or are leaking. In this technique, a larger incision across the breast or through the areola is made to remove both the capsule and the implant. A new implant is placed, and the incision is closed with sutures.

Both of these procedures are performed under general anesthesia at an outpatient facility or an accredited hospital. The procedures take between two to six hours depending on the technique used.

Stitches and dressings are used on the incisions to complete the procedure, and drains are placed to allow any fluids to drain out completely. Your surgeon may advise you to wear a surgical bra to help with the healing process.

How Long Does Recovery Take?

You can go home the same day as your procedure, and in a couple of days, it will be possible to return to light activities at home. You can resume work within a week or two.

Strenuous exercise needs to be avoided until you are completely healed, which may take up to six weeks. Your doctor will also advise you to avoid smoking and alcohol in order to speed up the healing process.

Make an Appointment to See Dr. Careaga

Dr. Daniel Careaga is an experienced surgeon with a great deal of skill, especially when it comes to breast procedures. Schedule an informative consultation with Dr. Careaga by contacting our office.


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