Capsular Contraction - Capsulotomy & Capsulectomy Surgery

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After breast augmentation surgery a side effect sometimes seen is something called ‘Capsular Contraction’ or ‘Capsular Contracture’.  Thought to affect around 5% of women who have breast implants, this can be a very painful problem that might need further corrective surgery to rectify.  The condition can occur very quickly after surgery, or might take a few months or even longer to develop, but either way it can prove rather painful for you, and will need to be resolved. 

Capsular Contraction Explained

When your implant is inserted, your body will start to create a shell around it, mostly consisting of a similar tissue to scar tissue.  This is a natural reaction by your body to protect you from a foreign body, and effectively seals it off so it can do you no harm.  Capsular contraction occurs when this shell surrounding the implant starts to heal itself and reduce, rather than remain fixed.  Scar tissue is not desirable for your body, and as a result some women will find that their breasts start to harden and become painful as their body tries to reduce the amount of scar tissue surrounding the implant.  This will put direct pressure on your implant, and can cause the breast to appear deformed, or very spherical in appearance.  

Forms of Capsular Contraction

Capsular contraction occurs to different severities, and is often judged in terms of grades. This is known as the Baker scale.

  • Minimal contraction, the breast remains soft to touch, appears very natural and causes little or no pain.  This level will not need any correction but ought to be watched, as it could get worse.
  • Slight contraction, the breast is slightly firmer than normal, but remains natural in appearance.
  • Moderate contraction, the breast is firm all round, is painful to touch and looks strange in shape.
  • Severe contraction, the breast is very firm, painful to touch or painful overall and is very deformed in appearance.

Each woman is different, and may be affected by capsular contraction to very different degrees.  It is very rare for someone to be affected by high grade capsular contraction, however when it does occur it can prove very painful and is likely to need further surgery.

Capsular Contraction Remedies

There are two main ways to address the problem of capsular contraction, however neither are guaranteed to be a permanent solution as the scar tissue may begin to develop after the corrective treatment.  The open capsulotomy procedure involves squeezing the breast externally in the hope of rupturing the scar tissue causing a tear to open up, releasing the pressure on the implant.  This is not the preferred method, as some people have very strong scar tissue, and the procedure can cause other problems to occur.  The other option is to have corrective surgery, also known as a closed capsulotomy, which involves a general anaesthetic and a surgeon to cut through the scar tissue.  This carries risks associated with any form of surgery, such as infection or allergic reactions, but is seen as the best way to tackle the problem with good results.  Some surgeons might also try lancing the implant or injecting steroids in order to help loosen the scar tissue and free the implant.

If you are concerned about the risk of capsular contraction, you can discuss it with your surgeon before you have breast augmentation surgery.  They will be able to give you clear answers and help you to avoid the problem as best they can. 

Symptoms of a Capsular Contraction »

Guide to Capsular Contraction