Breast augmentation: What is a capsular contracture and how can you prevent it?

After a breast surgery with the use of implants, the so-called capsular contracture with about 5 - 10% probability is a fairly common side effect. This forms a thin connective tissue layer around the implant, which is a natural reaction of the organism to the introduced foreign body.

The fact that a kind of scar tissue attaches to foreign material of any shape is quite normal - it is encapsulated as it were. However, it is unclear why this connective tissue layer becomes reactive in some breast implants and leads to a contracture (ie a contraction of the tissue).

Light forms of capsule fribose do not cause any problems

To a lesser degree, such a capsular contracture does not cause any difficulties and consequently does not need to be treated. In more severe cases, it can cause pain to the chest through a more or less pronounced contracture and visibly deform the breast externally.

One distinguishes the following degrees of expression of such a fibrosis:

  • Grade 1: Capsular contracture is not visible and not palpable
  • Grade 2: Capsular contracture is minimally palpable, but not visible
  • Grade 3: Capsular contracture is palpable and already minimally visible
  • Grade 4: Capsular contracture is painful and directly visible

This common schematization is somewhat simplified: even in mild cases, pain and unpleasant breast tension can be felt, while in other, severe cases with pronounced deformation of the breasts there are no complaints. Since you wanted to achieve an improvement of the optic with a breast augmentation, a potential deformation, possibly with pain, of course sounds alarming. The fact is that the severe forms are rare. Also, they can then be treated using a corrective surgery in which the capsular contracture is removed and the implant is replaced if necessary, usually satisfactory.

Reduce risks of capsular contracture

Since a certain bacterial strain (Staphylococcus epidermis) has been found more frequently in capsule fibrosis and may be associated with the development of contractures, the implants are usually rinsed with an antibiotic solution before insertion.

In addition, the material and surface condition of the implants may influence the formation of a capsular fibrosis. For example, it has been found that textured (ie rough) and silicone-coated breast implants rarely cause such problems as smooth, polyurethane-coated ones. And also the situation may play a role, because in subpectoral, so under the muscle implanted deposits, it is also much less common to capsule fibroses. Thus, if these factors are feasible in the individual case and freely selectable before breast augmentation, one can significantly reduce one's personal risk for subsequent complications in this way.

To prevent ingrowth of the encapsulated implant with the breast tissue, some experts also recommend regular and gentle chest massages after the operation. This simple method can often also significantly reduce the likelihood of contractures and pain.

Author: Dr. med. Monika Steiner