Scottsdale – The last time we discussed capsular contracture, we found there was a lot of interest on this subject. We are going to discuss more details about this condition that may affect up to 5 percent of women with breast implants.

In general, there is no way of telling who is going to develop capsular contracture, but several predisposing factors may increase your risk. The current scientific research on this condition implicates inflammatory conditions as the basic building block that leads to capsular contracture. In essence, any condition that leads to inflammation in and around breast implants can potentially lead to the formation of capsular contracture.

The goal of breast surgery is to place the breast implant into the appropriate location with minimal trauma and to reduce inflammation.

The factors that predispose to the formation of capsular contracture are discussed below:

  • Severe trauma to the breast. Any kind of trauma years and months later can affect the breasts. Reports of nipple piercings and car accidents, years after breast augmentation, leading to contracture are quite common.Trauma from surgery may lead to inflammation and increase the risks of contracture. An experienced, board certified plastic surgeon can perform breast augmentation while minimizing the amount of trauma to the breast itself. A clean and atraumatic separation of the muscles is what I prefer during breast augmentation surgery, always using a lighted retractor to see inside the pocket and gently separate the space for the breast implant.
  • Hematoma is a blood clot that is formed when there is bleeding into the pocket where the breast implants exists in your breasts. You should avoid blood thinners (coumadin, fish oil, vitamin E, ginko), platelet medications (aspirin, ibuprofen) before breast surgery and vigorous activity that raises your blood pressure and heart rate for a minimum of 2 weeks after breast implant surgery. A full list of medications that may thin your blood is available at the AB Guerra plastic Surgery Center.
  • Seroma is a collection of lymph fluid under the breast skin and surrounding the breast implant. Seroma formation is far more common in breast reconstruction, but can affect breast augmentation patients, in rare cases.
  • Bacterial infections can increase the risks of capsular contracture. Fortunately, frank infection is rare with the use of preoperative intravenous antibiotics. A more deceptive approach which bacteria take is the formation of biofilm communities which have been recently discovered. Double or triple antibiotic irrigation, nipple covers, and avoiding contact with the breast implant before insertion all reduce biofilm formation.
  • Silicone molecules leaching into the pocket surrounding the implant occurred quite commonly with old style silicone breast implants. The new cohesive gel, tripled-layered capsules silicone breast minimize this problem.
  • Breast implant placement above your muscle is more likely to lead to capsular contracture formation.
  • Autoimmune disorders are medial disorders that create inflammation in our bodies, potentially increasing the risk of contracture.
  • Smoking reduces the oxygen level in our blood and during healing. Less oxygen and the toxins in cigarette smoke combine to potentially increase the risks of contracture.
  • Radiation therapy used in the treatment of cancer can increase the risks of contracture when a woman undergoes breast reconstruction.

Not all forms of capsular contracture require treatment with Arizona plastic surgery. In part III of our capsular contracture series we will discuss what patients and doctors can do to reduce the risks of capsule contracture. There are four grades of breast capsular contracture, named, Baker grades I through IV.

The Baker grading is as follows:

  • Grade I - the breast is normally soft and looks natural.
  • Grade II - the breast is a little firm but looks normal.
  • Grade III - the breast is firm and looks abnormal.
  • Grade IV - the breast is hard, painful, and looks abnormal.

Treatment for capsular contracture will be discussed in part IV of our series.