Can You Prevent Capsular Contracture After a Breast Augmentation?

 Is capsular Contracture Preventable?

Prevention is better than cure right?

As the number one breast implant complication, capsular contracture (CC) is something you should be aware of as you start your breast augmentation journey.

If, like me, you want to know what you can do to have a smooth breast augmentation and recovery you may want to read up a bit more on capsular contracture.

Here's my look at it...

Capsular Contracture 101

Let’s get one thing straight... scarring after a breast augmentation is normal. In fact, your body will naturally create a wall of scar tissue around your implants.

What’s not normal is THICK scarring. It gets quite tricky here, because we don’t know exactly what causes thicker scarring. We do know that it’s a wrong immune response from your body.

So capsular contracture is a complicated complication!

 What is capsular Contracture ?

After the early breast augmentation recovery period if the scar tissue around the breast implant thickens too much it will squeeze the implant.

This squeezing (or tightening) of the scar tissue causes the breasts to look or feel different (the first sign of Capsular Contracture is increasing firmness) and can cause pain or discomfort in the breasts.

Can Capsular Contracture Be Prevented?

So, I’ve already said that we don’t know exactly what causes Capsular Contracture to occur. But, certain things are linked to Capsular Contracture. The top three things increasing the risk are:

  • too much blood or fluid around the implant after breast surgery

  • bacteria inside the breast after surgery (like an infection)

  • a ruptured breast implant

Rest assured your plastic surgeon will do everything they can to prevent it occurring. For example, they’ll minimize the risk from bacteria by:

  • giving intravenous antibiotics during your breast surgery

  • washing the surgical area with antibiotic solution

  • prescribing a course of antibiotics post-surgery

Other things (if you do Google it you’ll find there’s all sorts of suggestions) that are linked to lower chances of Capsular Contracture include:

  • breast massage – believed to keep the implant mobile in the breast pocket and prevent the scar tissue from clamping down on your breast implant (please check with your plastic surgeon before doing any kind of breast massage as some surgeons do not recommend it)

  • taking vitamin E tablets – believed to have softening effects on body tissue

  • having a crease (underboob) incision – there is less bacteria on the skin in this area of your body

  • placing breast implants under the muscle – an implant under the muscle is linked to less internal scarring

  • using a special material (called an acellular dermal matrix graft) inside the breast to create an ‘internal bra’ - this supports the breast implant and covers the parts on the side and bottom where the muscle doesn't reach

  • using a ‘no touch’ surgical technique – some plastic surgeons swear by the Keller funnel. It can only be used with silicone breast implants but ensures there is less chance of contamination since the implant isn’t touched as it enters your body

What Can You Do To Prevent Capsular Contracture?

By following your plastic surgeons instructions you’ll be doing everything you can to reduce your changes of developing capsular contracture. Unfortunately there is no guarantee that you won't develop capsular contracture.

No matter what you do the risk is still there.

 Capsular Contracture treatment

There's a lot to it, right?!

After what probably feels like a lot of scary information let me reassure you... the chances of Capsular Contracture occurring is between 1.5-10%, depending on the details of your breast augmentation.

Because implants are getting better and better, thankfully it is a much less common occurrence than it used to be.

Find out what your plastic surgeon does before, during and after surgery to reduce the chances of Capsular Contracture. But know, that no matter what is done during your breast augmentation, this is a biological process and no one can ever predict the outcome or necessarily prevent capsular contracture.

Perhaps when we know a bit more about what actually causes Capsular Contracture we’ll be able to aim for surgeries that totally prevent Capsular Contracture. There are research studies underway so the answers are definitely in our future!

Thoughts from Dr. Jeremy Pyle

Capsular contracture is a complicated thing. There are lots of potential reasons it can happen and some can't be prevented. Further, if you ask 50 plastic surgeons you will get very different responses.

Nonetheless, my approach is this: Do what we can to prevent it, but not what we can't.

I do believe that there is some value in the Keller funnel. I do believe there is value in meticulous surgical technique. I do believe there is value in cleaning with multiple solutions and using antibiotics in the OR and I do believe there is value in incision selection.

Each of those can be done with minimal risk or cost to you. Some doctors recommend antibiotics with any cleaning or dental procedure.

I can't yet get on board with that.

If you are 35 years old when you get implants, and you live another 50 years, that is at least 100 courses of antibiotics used while not treating an infection. Though it may decrease your risk of capsular contracture, it certainly increases your risk for really bad infections, allergies, GI upset and so on and so I'm just not on board with it yet.