Capsular Contracture Symptoms and Treatment

All surgeries have risks, and breast augmentation is no exception. Capsular contracture occurs when scar tissue forms around the implant, resulting in painful breast stiffness and possible leakage of the fluid inside the implant.

Women often fear this common complication because it is difficult to predict when it will occur and who will develop it. Most women start having symptoms around three months after their breast surgery, but you can develop capsular contracture at any time, and it can recur after it is treated.

Capsular Contracture: Are You at Risk?

Capsular contracture occurs in about 5 percent of women, and while there is no way of telling who is going to develop it, several factors may increase your risk. They include:

  • Autoimmune disorders
  • Smoking
  • Radiation therapy
  • Severe trauma to the breast
  • Hematoma (a break in blood vessel, causing localized bruising or blood clot)
  • Seroma (a collection of fluid under the skin)
  • Bacterial infections
  • Silicone molecules leaching into the pocket surrounding the implant
  • Breast implant placement. You may be more likely to develop capsular contracture when your implants are placed over your chest muscle (subglandular).

Detecting Capsular Contracture

Warning signs of capsular contracture include deformed, misshapen, and painful breasts, or breasts that are firmer than when they were first implanted. There are four levels of capsular contracture. They include:

  • Grade I: the breast is soft and looks natural
  • Grade II: the breast is slightly firm, but looks normal
  • Grade III: the breast is firm and looks abnormal
  • Grade IV: the breast is hard, painful, and looks abnormal

Capsular Contracture: Decreasing Your Risk

Some surgeons believe that placing the breast implant under your pectoral muscles significantly lowers your chance of developing contracture because of the constant massage that the implant receives from the muscles.

Other ways to decrease your risk for capsular contraction may include:

  • Taking a prescription corticosteroid drug called prednisone for two weeks.
  • Massaging your implants the day after surgery.
  • Performing compression exercises in which you squeeze the implant with medium pressure to keep the capsule flexible and loose.

Ask your breast surgeon for specific advice on how to decrease your risk for capsular contracture.

Treating Capsular Contracture: Will You Need a Revision Surgery?

In the past, the only remedy for capsular contracture was removing the implant and the residual scar tissue, but times are changing. Today, there are treatments for severe capsular contracture. Some surgeons may squeeze your breast and implant to break up the capsule. This can be painful, and may cause implant deflation or bleeding.

Other surgeons prefer to surgically lance the contracted tissue surrounding the implant to loosen it and break it apart. Additional treatments may include steroid injections and vitamin E.

New technologies are being developed to treat capsular contracture, including the use of sound waves to soften the breasts. However, even if your symptoms are effectively treated, it is possible to develop capsular contracture again.

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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
    10 Chester Avenue
    Second Floor
    White Plains, NY 10601
    (914) 421-0113
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    Bahman Guyuron, MD

    29017 Cedar Road
    Lyndhurst, OH 44124
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