Reasons for Breast Revision Surgery: Addressing Capsular Contracture
Breast augmentation is one of the most popular cosmetic procedures worldwide, but in some cases, patients may require a secondary surgery known as breast revision. One of the most common reasons for breast revision surgery is capsular contracture—a condition where scar tissue forms around a breast implant, leading to discomfort, aesthetic concerns, and potential complications. Understanding the causes of capsular contracture and the surgical options available can help patients make informed decisions about their care.
What Is Capsular Contracture?
Capsular contracture occurs when the body’s natural healing response forms an excessive or abnormally thickened capsule around a breast implant. This capsule can tighten over time, causing the breast to feel firm or hard and sometimes leading to pain and distortion of the implant’s shape. The severity of capsular contracture is classified using the Baker Scale:
Grade I: The breast feels soft and appears natural.
Grade II: The breast is slightly firm but still looks normal.
Grade III: The breast is firm and shows visible distortion.
Grade IV: The breast is hard, painful, and significantly misshapen.
Causes of Capsular Contracture
While the exact cause of capsular contracture remains unclear, several factors are believed to contribute to its development:
Bacterial Contamination – The presence of bacteria around the implant can trigger an inflammatory response, leading to excessive scar tissue formation.
Hematoma or Seroma – Blood or fluid accumulation around the implant can increase the risk of contracture.
Surgical Technique – Poor implant placement, lack of sterile techniques, or excessive tissue handling can lead to complications.
Implant Characteristics – Textured implants generally have a lower risk compared to smooth implants, but both types can be affected.
Genetic Predisposition – Some individuals may have a higher tendency to form excessive scar tissue due to their genetic makeup.
Trauma or Injury – Physical impact or excessive pressure on the implant can contribute to capsular contracture.
Surgical Options for Capsular Contracture
Patients experiencing capsular contracture may require surgical intervention to relieve symptoms and restore a natural breast appearance. The choice of procedure depends on the severity of the contracture and patient preferences.
Capsulectomy – This procedure involves the complete removal of the thickened capsule surrounding the implant, often followed by implant replacement.
Capsulotomy – In a capsulotomy, the surgeon makes incisions in the capsule to release the tightness and improve the breast's feel and appearance.
Implant Exchange – In some cases, replacing the current implants with new ones, such as switching from smooth to textured implants or vice versa, can help reduce recurrence.
En Bloc Capsulectomy – This technique involves removing the implant and capsule as a single unit, often recommended for severe cases or when there are concerns about implant integrity.
Pocket Change Procedure – Moving the implant from a subglandular (above the muscle) to a submuscular (below the muscle) position can lower the risk of contracture recurrence.
Use of ADM (Acellular Dermal Matrix) – Some use ADM materials to create a barrier around the implant, reducing inflammation and scar formation.
Preventing Capsular Contracture
While not all cases of capsular contracture can be prevented, the following strategies may help reduce the risk:
Choosing an experienced, qualified doctor who follows meticulous surgical techniques.
Opting for submuscular implant placement when possible.
Ensuring strict sterile protocols to minimize bacterial contamination.
Following all post-operative care instructions, including massage techniques if advised.
Considering antibiotic irrigation during surgery to decrease bacterial presence.
Conclusion
Capsular contracture is a common reason for breast revision surgery, but with advanced surgical techniques, patients can achieve relief from discomfort and restore their desired breast aesthetics. If you are experiencing symptoms of capsular contracture, consulting a qualified doctor is the first step toward finding the right solution for your needs.
At Norwest Cosmetic Surgery, Dr. Senthil Supramaniam focusses in breast revision procedures, offering tailored solutions to help patients address the above mentioned issues. Book a consultation today to discuss your options.
