Capsular Contracture

One of the main contraindications of having breast enlargement surgery is capsular contracture, in simple terms this means;

When a breast implant is inserted, your body naturally heals around it. During this healing process, your body will form a lining (like scar tissue) around the implant. The amount of scar tissue formed and the speed at which the body heals itself is entirely dependent on the individual as everybody is different. If your body produces too much scar tissue lining too quickly, it can encapsulate the implant which will cause the implant to feel hard. If this happens, the implant may become misshaped due to the pressure of the lining manipulating its structure and positioning within the breast. In some cases this can cause slight discomfort.

Encapsulation can happen at any time but is most common in the first several months after surgery. It is important to remember that it is not the implant that is hard but the lining pressing on and compressing the implant making it feel harder than it should. Once the scar tissue has been removed, the implant will look and feel exactly the same as when it was first inserted.

There are different grades of capsular contracture which can be measured on a scale called the Baker Grading System. There are 4 grades:

• Grade 1 – As everyone produces a lining around the implant, this grade is a healthy and normal amount of scarring which leaves the implant soft and natural.
• Grade 2 – Slightly more scarring results and the breast is a little firm but still appears natural. The breast can be left as they are if the patient is happy with them.
• Grade 3 – At this stage the breast is firm and is beginning to look misshaped. The patient will probably want the extra lining removed, which can be accomplished via re-augmentation surgery.
• Grade 4 – The breast is hard, has lost its shape and may cause slight discomfort. Patients at this stage will also require re-augmentation surgery to remove the problematic lining./li>

What causes capsular contraction?

There is no way to predict who will and who will not experience encapsulation following breast surgery as it is impossible to tell how each individual's body will react to the insertion of implants. There are a few factors that have been said to increase chances of encapsulation which are:

1. It is thought that capsular contracture is more common if you have implants over the muscle then if you had them sub muscular.
2. Encapsulation is more likely after an infection, following breast surgery.
3. If you have had a seroma (a tumour-like mass or accumulation of serum in a tissue or organ that often occurs following surgery), you may be at more risk to capsular contracture.
4. Hematomas (a pocket or localized collection of blood within the tissue) can cause an inflammatory reaction, which can lead to encapsulation.
5. Smoking decreases the oxygen levels in the blood, which could make the healing time slower and could possibly cause an inflammatory reaction. Smoking also increases risk of infection.

What to do if you think you have Capsular contracture

If you think you have encapsulation then there is no need to worry as, in most cases, it can be fixed. If you think you have slight encapsulation (like grade 2) then there is no need to do anything about it unless the situation deteriorates. If your breasts are showing the signs that you have grade 3 or 4 encapsulation, the best thing to do is go back to your surgeon to find out if they think it is necessary to have further surgery. You surgeon will simply re-open the implant pocket and remove the excess lining that your body has produced and re-insert the implant.

Most companies offering breast enlargement will have an aftercare policy that should cover the costs involved with encapsulation surgery. It is therefore vital to check the terms and conditions of surgical procedures within initial consultations to ensure that complications such as encapsulation are fully accounted for.

If capsular contracture has been corrected, it is important to remember that there is no guarantee that it won't happen again. Unfortunately encapsulation could occur a second or third time. If this is the case, the surgeon may ask a patient to re-consider having implants at all due to their body's rejection of these foreign objects. However, this is extremely very rare.

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