What is capsular contracture?

Capsular contracture is defined as the formation of a tight and sometimes painful scar tissue capsule around breast implants. The body naturally responds to foreign objects, such as breast implants, by forming this capsule to encapsulate and isolate them. The course of treatment for capsular contracture can vary depending on the severity and stage of the condition. Many times, surgical intervention, such as a total capsulectomy, is recommended to address the problem and restore the patient’s breast look and comfort. Board-certified Dallas plastic surgeon Dr. Solomon Azouz can provide the best treatment options for capsular contracture and help maintain the results of your breast augmentation. Sometimes nonsurgical management can also be an option, depending on capsule formation.

What is a breast implant capsule?

A breast implant capsule, often known as a “capsule” in the context of breast augmentation, is the body’s natural reaction to the presence of a breast implant. Following breast implant surgery, the body begins to create a fibrous tissue capsule around the implant. This capsule, which is mostly made of collagen fibers and connective tissues, serves to isolate and protect the implant from the surrounding breast tissue. The capsule is often thin and pliable at first, allowing the breast to retain its natural appearance and feel. But depending on a number of factors, its density and thickness can fluctuate. With capsular contracture, the capsule thickens excessively and causes discomfort and changes in breast shape.

What are the symptoms of breast implant contracture?

Patients with capsular contracture may have a variety of symptoms, including breast pain, hardness, and tightness. The breasts may appear unusually formed, and patients might feel asymmetry between the breasts. In some situations, apparent rippling of the implant might occur, causing discomfort and affecting the cosmetic appearance of the breast.

The severity of capsular contracture is frequently categorized into four stages, known as Baker grades, that help in determining the severity of the condition:

• Baker Grade I (Subclinical): At this early stage, the breast appears and feels normal, and the patient reports no severe symptoms or discomfort. The scar tissue around the implant is thin, soft, and flexible, with no obvious breast deformity.
• Baker Grade II (Mild): At this stage, the patient may observe some modest alterations in the breast. The scar tissue capsule has grown and become slightly harder, but it does not produce apparent discomfort or substantial changes in breast shape.
• Baker Grade III (Moderate): Capsular contracture becomes more visible at this level, with noticeable symptoms. The breast may feel noticeably stiff and have a deformed look, with some obvious asymmetry. Patients may suffer minor discomfort or soreness, especially if pressure is applied to the breast.
• Baker Grade IV (Severe): This is the most advanced level of capsular contracture. The scar tissue surrounding the implant is dense, tight, and rigid, causing severe breast deformity and discomfort. The breast may appear deformed, and the patient frequently experiences pain, soreness, and limited movement.

Who is a candidate for capsular contracture surgery?

Many individuals who are suffering from the discomfort of capsular contracture may be candidates for surgery. Some patients may develop a breast implant rupture or a leaking breast implant. When a breast implant ruptures, whether saline or silicone, it might cause an inflammatory response. This inflammatory response can result in the production of new scar tissue, thickening and tightening the current capsule, and ultimately contributing to the development of capsular contracture. Following a thorough examination, board-certified plastic surgeon Dr. Azouz will determine the severity of the contracture and the patient’s overall health and consider the patient’s goals to determine the best treatment plan for capsular contracture.

What are the benefits of capsular contracture surgery?

A capsular contracture surgery can help:

• Relive pain and discomfort caused by capsular contracture
• Restore a more natural appearance to the breast by eliminating the scar tissue
• Correct implant malposition or asymmetry, resulting in a more balanced and aesthetically acceptable appearance
• Improve overall breast health and patient comfort, increasing quality of life

What is the treatment for capsular contracture without surgery?

Capsular contracture treatment varies based on the patient’s symptoms and severity. In mild situations, nonsurgical treatment for capsular contracture, such as medicines or formal massages, may be indicated.

• Medications: In milder cases of capsular contracture, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and prescription medication may be advised as part of the therapy approach. These drugs help manage discomfort and inflammation. Dallas plastic surgeon Dr. Azouz may prescribe appropriate medications to alleviate discomfort and reduce inflammation in patients with capsular contracture, assuring their well-being and comfort throughout the treatment process.
• Breast Massage: To treat capsular contracture, breast massage techniques can be used under the supervision of a medical professional. The purpose of these massages is to relax the scar tissue capsule and ease discomfort by gently massaging the breast. Baoard-certified plastic surgeon Dr. Azouz may recommend various massage techniques to his patients, ensuring a personalized approach and ultimately working toward treating capsular contracture.

Even though these nonsurgical techniques could help with less severe cases or work well in combination with surgical treatments, they might not always offer a long-term solution. Depending on the demands of each patient and the severity of the condition, surgery or nonsurgical treatment may be chosen. Dr. Azouz will assess your condition and decide on the most effective course of treatment for capsular contracture.

What is the surgery for capsular contracture?

Surgical treatments such as capsulectomy (partial or total), implant exchange, or en bloc capsulectomy are commonly used to remove or release the troublesome scar tissue capsule and, in certain situations, replace the implant. When it comes to treating more severe or advanced cases of capsular contracture, these surgical treatments are generally successful.

Total Capsulectomy:

Total capsulectomy is a surgical treatment performed by board-certified plastic surgeon Dr. Azouz in which the entire scar tissue capsule covering the breast implant is carefully removed. If necessary, this procedure may include the removal and replacement of the implant itself. In cases of severe capsular contracture, total capsulectomy is frequently used to efficiently address the problem and restore both comfort and the natural appearance of the breast.

Capsulotomy:

A surgical procedure known as capsulotomy may be considered for less severe cases of capsular contracture. Incisions are made in the existing capsule to alleviate tension and soften the breast during the capsulotomy. Dallas plastic surgeon Dr. Azouz may suggest this procedure for patients with mild to moderate contracture, providing a customized treatment to address their unique problem and restore breast aesthetics.

Implant Exchange:

Implant exchange is a possible treatment option when capsular contracture is suspected to have developed as a result of the breast implant itself. During this process, the old implant is removed and replaced with a new one. With his experience in breast implant revision surgery, Dr. Azouz can suggest implant exchange as a component of a whole treatment plan to properly manage the problem.

En Bloc Capsulectomy:

En bloc capsulectomy is a surgical method that may be used in advanced cases of capsular contracture. In this procedure, the surrounding scar tissue capsule and the breast implant are removed in their entirety. Expert in handling complicated situations, Dr. Azouz might suggest en bloc capsulectomy to ensure complete treatment, giving patients relief and the best possible outcome.

What is the anesthesia for encapsulated breast implant removal surgery?

For capsular contracture surgery, board-certified plastic surgeon Dr. Azouz uses local anesthesia and sedation to help control pain during and after the procedure. This ensures that his patients are comfortable during the procedure and allows for a safe and rapid recovery.

What are the risks of surgery?

Surgery for capsular contracture, like any other procedure, entails risks such as bleeding, infection, scarring, and changes in breast feeling. During the consultation, Dr. Azouz will go over the risks in detail, emphasizing that every effort is taken to reduce them and assure patient safety.

What is the recovery from surgery?

The time it takes to recover from capsular contracture surgery varies from patient to patient, although it usually takes several weeks. Mild swelling and soreness are to be expected in the immediate days following surgery. Dr. Azouz provides detailed post-operative instructions, including pain management recommendations and the use of compression garments. Dr. Azouz will assess your progress and make specific recommendations for a quicker recovery at your follow-up appointments.

What procedures can be combined with capsular contracture surgery?

Capsular contracture surgery can be combined with other cosmetic treatments, such as breast implant replacement, breast lift, liposuction, or a tummy tuck. Combining procedures is decided on an individual basis and can be discussed during your consultation with Dr. Azouz.

What is the cost of the capsular contracture surgery?

Depending on the unique circumstances and the particulars of the case, the cost of capsular contracture surgery can vary. Patients will receive a customized cost estimate tailored to their specific needs during their consultation with Dr. Azouz.

Schedule a consultation with Dr. Azouz in Dallas

If you are having capsular contracture symptoms or are considering surgery, contact board- certified Dallas plastic surgeon Dr. Azouz. His experience and sensitive care will assist you through the process, ensuring you receive the best possible results. Contact the office at (972) 702-8888 to take the first step toward a more comfortable and aesthetic outcome.

Frequently Asked Questions

Is capsular contracture surgery painful?

Some patients report mild discomfort after surgery which can be controlled with prescribed medications. During the procedure, Dr. Azouz uses local anesthesia with sedation which can help to control pain for up to 24 hours after the surgery.

Will there be visible scarring after capsular contracture surgery?

Board-certified plastic surgeon Dr. Azouz aims to minimize scarring and makes camouflage incisions strategically. Scars typically fade over time and become less noticeable.

Can I choose a different implant type or size during capsular contracture surgery?

Yes, during the consultation, you have the opportunity to discuss and choose a different implant type or size with Dr. Azouz to achieve your desired outcome.

Are the results of capsular contracture surgery permanent?

The results are intended to be long-lasting, but it's important to follow post-operative care instructions and attend regular follow-ups to monitor the condition of the implants.