After a breast augmentation procedure, a capsule-like border of protective scar tissue or collagen fiber forms around each breast implant. This is a normal immune response to any implant in the body.
Unfortunately, in some cases, a complication known as capsular contracture occurs. With this condition, the scar-tissue capsule is thicker than normal. It contracts, making the breasts feel hard and the implants (and breasts) look deformed. The tightened tissues in the breasts can also cause discomfort.
The contracture can affect only one breast or both. The reason behind capsular contracture is not yet known.
You may notice that one breast feels harder or looks different from the other breast or you may feel some discomfort in one of the breasts. You should go to your doctor immediately if you see any of these symptoms. The doctor will do a physical examination to confirm if it is a capsular contracture. The doctor will diagnose the condition of your breasts according to the following gradations.
Grade 1: The breasts are soft and normal.
Grade 2: One of the breasts is not so soft and the implant can be felt.
Grade 3: The breast feels very firm and the implant can be easily felt. The distorted shape of the breast is easy to see.
Grade 4: The breast feels quite tender and painful and is very hard. The breast looks misshapen.
Sometimes, the doctor can also do an MRI, a mammogram, or an ultrasound to diagnose the thickness of the scar tissues. Most of the time, this is not required.
Treatment Options for Capsular Contracture
Medicine – Zafirlukast (Accolate) can help in softening the capsule of protective tissue around the breast implant. Taking the medicine twice a day for a period of 90 days can make the scar tissue much softer. Accolate has also been proven to reduce the recurrence of capsular contracture. Taking 20 mg of Zafirlukast daily is sufficient. Your doctor may prescribe this medicine two weeks before the augmentation surgery as a preventive measure.
Revision breast surgery – Thick scar tissues may be removed surgically. This procedure is known as a capsulectomy as part of revision breast surgery. During this process, the entire capsule of thickened and hardened protective tissue around the implant is removed. It reduces the chances of a recurrence of any capsular contractures in the future. The surgical method is much more effective than the other methods of capsule elimination.
Reducing the Chance of Capsular Contracture
Using textured implants – The rough surface of an implant will prevent the formation of a hard capsule around it. It’s important to note that this works only in sub-glandular breast augmentation.
Placement of the implant – If the implant is placed below the breast muscle, the chance of capsular contracture reduces to 8% to 12%. If it is placed completely under the chest muscle, the risk reduces to 4% to 8%.
Arrange a Consultation with Our Office
If you believe that you may have capsular contracture and are suffering from its symptoms, contact our office and schedule a helpful consultation with Dr. Jaime Schwartz. Dr. Schwartz is a board-certified plastic surgeon and will be available to answer your questions.