Treatment for Capsular Contracture

Capsular Contracture is the buildup of capsular tissue around a breast implant that contracts around the implant leading to firmness or hardening of the breast, distortion of breast shape, and even pain. For further information about capsular contracture and its possible causes see our previous blog post HERE.
The treatment for capsular contracture will depend upon the severity of the contracture. The sooner treatment begins the more likely that less invasive approaches will be successful. So if you suspect you are developing capsular contracture, get into see your surgeon. The sooner you can start treatment for capsular contracture the greater chance you can avoid additional surgery.
The least invasive treatment measures for capsular contracture are nonsurgical. They include massage and medications. Increasing your daily dosage of vitamin E can be effective. Vitamin E rubbed on an external scar will soften tissue and orally taken vitamin E can have the same effect on contracted capsule tissue. Your plastic surgeon probably recommended that you take vitamin E after your augmentation and Dr. Petersen recommends continuing that practice. To recommend breast massage may be a bit misleading. This is not your relaxing, rub some oil on in the bath tub kind of massage. This kind of therapeutic breast massage involved aggressively squeezing the breast from side to side and up and down along the chest wall. The goal is to move the implant within the capsule pocket. Breast massage is meant to loosen capsular tissue. Finally, Accolate, a drug generally used for treating asthma patients, has shown promise in treating early capsular contracture. This is not a guarantee and studies have been limited. Click HERE to read research on Accolate and capsular contracture. But studies have not shown ill effects of using the prescription drug and so Dr. Petersen feels this is a great place to begin conservative treatment. This treatment may last 3-6 months or longer depending on its effectiveness for individual patients.
If the above conservative treatments are found ineffective or the capsular contraction is found to be too advanced for conservative treatment, the next option may be a closed capsulotomy. This treatment has mostly fallen out of favor in the plastic surgery community. It essentially involves the surgeon manually squeezing the breast in an effort to rupture the capsule surrounding the implant. Generally this is very painful for the patient. Internal bleeding may result and the capsule may not rupture evenly leaving residual misshapen breast appearance. In addition, it has a higher likelihood of recurrence and could potentially damage your implants. Dr. Petersen generally does not perform closed capsulotomy unless there are extenuating circumstances that warrant it.
The two surgical methods for treating capsular contracture are an open capsolotomy and a capsulectomy. Which one is right for a given patient is based on the severity of the contracture and its resulting symptoms. An open capsolotomy involves the surgeon entering the capsule and scoring the inside. Essentially this means the surgeon cuts stripes in the inside of the capsule surrounding the implant releasing tension and pressure. A capsulectomy involves removing the capsule around the implant all together and allowing a new capsule to form. Dr. Petersen would recommend vitamin E, breast message, and Accolate after both of these surgical interventions.
Statistically speaking, once you have had a capsular contraction you are at higher risk for another one. But it is not necessarily true that capsular contraction will reoccur. That is why careful monitoring and post-surgical breast care are so important. If you have questions, give us a call!