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Breast Implant Capsular Contracture is a complication of breast augmentation or reconstructive surgery in which the capsule of scar tissue that normally forms around the breast implant tightens and hardens. This can create discomfort, distortion of the shape of the breast, and, in some instances, pain. However, to know about the further causes and symptoms, it is better to have a brief understanding of it.
An Introduction to Capsular Contracture
In the process of breast augmentation there is a pocket which is created within the tissue of the breast to house the implant. The body responds to this foreign entity by developing a capsule of collagen-rich scar tissue around it. This capsule is usually thin and flexible and the implant can move naturally, while the breast can remain soft.
In capsular contracture, however, this capsule becomes abnormally thick and rigid, and thus the implant starts feeling hard while the breast may become misshapen. Many patients get to experience the extreme pain due to capsular contracture, from grades I to IV.
The Four Grades of Capsular Contracture
Understanding breast implant capsular contracture grades is important in assessing the severity and the type and level of interventions required or necessary.
| Grade Level | Texture and Appearance |
| Grade I | The breast feels soft and natural. The implant is in a good position and the contour of the breast is not distorted. The capsule is thin and pliable and the implant can be moved freely.
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| Grade II | The breast is slightly firmer than usual, and the feel of the breast has changed from normal, but it doesn’t look unnatural. There is some alteration in the sense of the breast, but minimal distortion in the shape or symmetry of the breast. |
| Grade III | The breast is significantly harder, and there is an initial distortion of its shape. The hardness begins to affect the cosmetic outcome, whereby the breast looks slightly distorted or asymmetrical.
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| Grade IV | The breast is very firm and distorted in shape. The tightness of the capsule results in the implant feeling hard, while the breast may appear to be significantly misshapen. The appearance and feel are notably different from the normal post-surgical outcome. |
What are the Causes of Capsular Contracture?
Capsular Contracture of Breast Implant can be caused owing to various factors. Some of these are:
1. Infection
The most common factor related to capsular contracture is infection. Bacterial infections, especially those due to Staphylococcus aureus, can lead to an inflammatory reaction resulting in the deposition of extra scar tissue around the implant. Low-grade, subclinical infections can also be one of the causative factors.
2. Implant Leakage or Rupture
Inflammation and an abnormal immune reaction can result from leakage or rupture of the silicone or saline within an implant. This is partly because the capsule, as a result of body efforts to contain such a foreign material, becomes thicker and more rigid, causing capsular contracture breast implants.
3. Bleeding
Hematoma is an accumulation of blood due to bleeding around the implant site caused by surgery or injury. This can raise the chances of capsular contracture because of the greater deposition of scar tissue by the body in response to the blood.
4. Surgical Technique
The risk of capsular contracture may also be related to the type of surgical approach. It may have to do with where the implant is positioned (above or below the muscle), whether the implant used is textured or smooth, and how well the pocket is created. A misplaced position of the implant or one that traumatizes surrounding tissue too much would contribute to a higher risk.
Preventive Measures for Capsular Contracture
1. Type of Implant and Placement
The choice of type of implant and placement may affect the risk of capsular contracture. Both silicone and saline implants have been used with success, but silicone implants tend to produce fewer contractures because of their cohesive gel, which approximates more naturally the breast tissue.
2. Avoid Smoking
This will cause the flow of blood to diminish, severely affecting the process of recovery. Smoking promotes several complications, which may include capsular contracture. So, if you smoke, it is a good time to quit well in advance of your surgery and remain free from smoke until your recovery periods are complete.
FAQs
1. How can capsular contracture be diagnosed?
Capsular contracture of breast implant can be diagnosed through a physical examination conducted by a healthcare professional. However, in certain cases, imaging studies like MRI or ultrasound can also be used to understand the severity.
2. Can capsular contracture be prevented?
Capsular contracture might not be entirely preventable. Certain practices can reduce the risk of it, such as using textured implants maintaining aseptic techniques during surgery, and even using medications.
3. How can capsular contracture be treated?
Treatment options can vary depending on the severity of the problem. Treatments might involve non-invasive solutions such as therapy, and massage.
4. Can capsular contracture recur after treatment?
There are possibilities that capsular contracture breast implants might recur after treatment. You will need to keep up with your follow-up visits with the surgeon to monitor your healing progress.
5. Will there be any long-term effects of capsular contracture?
In most of the cases, patients do not experience any long-term effects. But maintaining your breast health is important.
6. Are textured implants better for capsular contracture?
Surgeons believe that textured implants are better to reduce the risk of capsular contracture, but recent developments prove it to be doubtful.
7. Does implant size play a part in capsular contracture?
The larger the implant size, more will be the risk of capsular contracture, but the overall risk is also influenced by other factors.
The Bottom Line
The treatment for capsular contracture breast implants, if it sets in, is based on the degree of severity. However, before deciding on any treatment, it is always better to consult with a surgeon. Find the best destination and choose the right treatment for you.