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What is capsular contracture?

Capsular contracture is a complication that can arise after getting breast implants. When breast implants are inserted, the tissue that naturally forms around them (the body forms tissue around any foreign object that is inside of it) is called the capsule. When this tissue becomes infected, it begins to thicken and tighten, and it contracts, or squeezes, the breast implants. This causes breast pain and firmness.

Treatment of capsular contracture

Once you notice any indication of capsular contracture, it’s vital to contact Dr. Alizadeh quickly. The condition will not go away on its own, and in fact will worsen, making it vital that you undergo your capsular contracture treatment in NYC with Dr. Alizadeh soon as possible. He will properly and effectively treat the condition, starting with an exam and a diagnosis. The procedure itself may require different approaches, depending on your unique situation.

Capsular contracture treatment begins with making the incisions. These are made in the same place as they were made in your original breast implant procedure. Once the incisions are made, Dr. Alizadeh may simply remove the capsule tissue, or if it is required, he may remove both the capsule tissue and the implant.

  • Removal of a portion of capsule tissue - This procedure is possible if the capsular contracture is caught early enough. A portion of the tissue may be removed, rather than the tissue and the implant itself. This procedure effectively creates more space in the breast pocket and can correct early capsular contracture.
  • Secondary breast augmentation with a capsulectomy -
    If capsular contracture is more advanced, the tissue and the implant will both need to be removed. This procedure is called a capsulectomy. During this procedure, new implants may be placed if you would like your breast to remain augmented. 
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After your capsular contracture surgery is complete, you may return home with a friend or family member who can help you. Expect some pain and swelling, which begin to diminish after the first week. You will wear a surgical bra to help reduce swelling and support your breasts for a period of weeks. 

Many women find their recovery after capsular contracture surgery to be easier than their first breast implant surgery. You should be able to return to work or your usual activities within a week or so, once you feel more comfortable and swelling has subsided. You will likely feel healed after a couple of weeks, but it is important to remember that the breasts need time to settle into their new position and fully heal. Do not lift anything more than ten pounds or engage in any strenuous exercise for six weeks. 

Diagnosing capsular contracture

If capsular contracture occurs, it will usually happen within the first few months after your breast augmentation procedure. You may notice the signs of capsular contracture as soon as 4-6 weeks after surgery, or in the following 3-4 months. However, once six months have passed, capsular contracture is very uncommon.

As a part of diagnosing capsular contracture, Dr. Alizadeh will ask about your symptoms and examine your breasts. Dr. Alizadeh may perform other tests in his private NYC practice, to ensure the diagnosis is correct. He will diagnose your condition based on your symptoms, breast appearance, and other factors which allow him to properly ascertain the exact situation and how it will be best addressed.

Grades of capsular contracture

Diagnosing capsular contracture includes the degree of capsular contracture. A grading system for capsular contracture is used–I through IV. The first grade is a soft, normal capsule, where the breast looks and feels as it usually would. The fourth grade is the most severe, in which a woman’s breast feel and look hard and painful. 

  • Grade 1: Natural-looking and feeling, soft breasts.
  • Grade 2: Slightly firm breast, but the appearance is still natural.
  • Grade 3: Firm, abnormal appearance and uncomfortable-feeling breast.
  • Grade 4: Hard, painful, abnormal-looking breast, including nipple irregularities.

Grades 3 and 4 require surgery. 

Symptoms of capsular contracture

Capsular contracture is painful, but there are other symptoms to keep in mind that can be a sign of capsular contracture:

  • Breast firmness or tightness
  • Hard, painful breast
  • A change in breast shape
  • A change in breast position
  • Restricted or uncomfortable range of motion
  • The breast is unusually round or ball-shaped
  • The breast is unusually high on the chest wall
  • The breast is misshapen 

Who is at risk of capsular contracture?

Some are more prone to capsular contracture because of genetics. If there is a family history auto-immune disorders, the risk of capsular contracture may be greater. However, the most common occurrence of capsular contracture happens by random chance. There is no certain preventative against capsular contracture because the causes are not fully known.

Despite this, there are points to keep in mind that may help reduce the potential of capsular contracture happening, including the following:

  • Silicone implants have a higher risk than saline implants of developing capsular contracture.
  • Smooth-textured implants may have a lower chance of developing capsular contracture.
  • When implants are inserted under the muscle tissue in the chest, they may be less likely to develop capsular contracture when compared with implants inserted over the muscle tissue. When the implants are under the pectoral muscles, the muscles massage the implants as you make your usual, normal movements. This massage helps the scar tissue to remain soft.
  • Gently massaging the breasts after your breast augmentation, under your doctor’s instructions, can help to keep the breast tissue pliable during the healing process, which may help to prevent capsular contracture.
  • Choosing the right size of implants can be an important part of preventing capsular contracture. If the implant is too large and the patient doesn’t have enough natural breast tissue to cover the size of the implants, the risk of developing capsular contracture is higher. For patients with small breasts who would like a significant size increase, the augmentation can be done in stages. This will start with a mid-size implant, then after a period of time has passed and the skin has stretched, move to a larger implant. 
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Causes of capsular contracture

The exact cause of capsular contracture is not known, but it is likely the causes vary from patient to patient. The following are believed to be likely causes of capsular contracture.

Bacterial infection

A thin year of bacteria, called biofilm, can form inside the breast pocket. This bacteria forms after being introduced to the body during the initial breast implant procedure. The bacteria may cause infection, which could lead to capsular contracture. Dr. Alizadeh takes utmost caution and follows strict, rigorous protocols to avoid this, including keeping any handling of the implants as minimal as possible before they are inserted. 

Hematoma (blood accumulation) and seroma (fluid accumulation)

A hematoma or seroma can provide nutrients for bacteria to feed on. This increases the chance of biofilm growing and developing, which increases the chance of capsular contracture. Drains can be helpful in avoiding blood and fluid accumulation for patients who require it. 

Incomplete breast cancer treatment

When breast implants are inserted for radiation treatments for breast cancer treatment is complete, this may increase the risk of capsular contracture.

Genetic predisposition

Genetics can cause different concerns. Because of genetic disposition, thick scar tissue may form more easily. A family history of autoimmune disease may also create a higher risk of developing capsular contracture.

Random chance

From what physicians know, capsular contracture has no easily identifiable source. While the above causes are possible in different cases, they cannot be easily predicted. Ultimately, capsular contracture appears to come down to chance.

Why choose Cosmoplastic Surgery for capsular contracture treatment?

Dr. Kaveh Alizadeh is a fellowship-trained, double Ivy-league alumnus with over 23 years of experience, and the founder and medical director of Cosmoplastic Surgery. Dr. Alizadeh specializes in breast procedures and is known as a precision artist with the female figure. His compassionate, professional and effective approach is why he is in such high demand by women who would like to achieve their ideal feminine physique.

A distinguished Professor of Clinical Surgery at New York Medical College, Dr. Alizadeh is a leading figure in his field. In his impressive career, he has trained over 100 plastic surgeons and served as the oral examiner for the American Board of Plastic Surgery. He has authored numerous peer-reviewed articles and presented over 100 international lectures focusing on his specialty. Most noteworthy, he is currently the primary clinical trial investigator for the FDA, where he has significantly contributed to advancing various medical devices such as breast implants. Having taught his techniques in over 25 countries and provided patients with free healthcare via his nonprofit, Mission: Restore, Dr. Alizadeh’s reach is international in scale.

Your capsular contracture treatment in NYC with Dr. Alizadeh will be performed at our state-of-the-art and fully certified American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). 

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