One of the Most Common Complications of Breast Augmentation is Capsular Contracture

Capsular contracture is one of the most common complications of breast augmentation.  Capsular contracture is the development of large amounts of scar tissue surrounding the breast implant and contracting around the implant.  The contracting scar tissue squeezes the breast implant.  Mild cases of capsular contracture may result in firmer feeling breasts.  More severe cases of capsular contracture can result in mishapen breasts and even pain.

It is perfectly normal for scar tissue to develop around a breast implant.  Because the breast implant is a foreign object, the body forms a pocket around the implant called a capsule.  The capsule is the body’s way of protecting itself from a foreign object invading its space.  The problem is that in some women this scar tissue becomes thick and the capsule shrinks around the implant.  This can happen in just one breast or in both breasts.  It can happen within the first year of surgery or it may not happen until many years after surgery.  This unpredictability can be frustrating.  A woman may have no problems with her implants for many years, and then slowly everything changes.

What Causes Capsular Contracture?

The causes of capsular contracture are unknown.  One theory is that bacteria in the capsule cause a reaction.  For this reason sterile technique during surgery is important.  Dr. Petersen uses an antibiotic solution to wash out the breast cavity before placing the breast implant.  He also changes surgical gloves regularly during surgery.  Every effort is made to keep the implant and the breast cavity clear of bacteria and contaminations.  But capsular contracture may just be an individual’s way of making scars—and there is nothing the surgeon can do to prevent that.

Dr. Petersen does encourage his patients to do some things that MIGHT help prevent capsular contracture.  I emphasize that these practices might help because there are no conclusive studies about capsular contracture that tell us how to prevent it.  Dr. Petersen encourages all his augmentation patients to take vitamin E supplements daily.  Vitamin E is known to help soften scars.  Vitamin E lotion or oil used regularly on an external scar will improve the appearance of a scar.  Taken internally the same mechanisms improve internal scaring.  Dr. Petersen encourages his patients to remain on vitamin E supplements for as long as they have implants because capsular contracture can develop even years after surgery.

The second thing Dr. Petersen recommends is daily breast massage.  A couple of minutes each day, maybe while in the shower, squeeze the breast from side to side and up and down.  You want to feel the implant move during massage.  Like the vitamin E, Dr. Petersen recommends this daily regimen for as long as the implant is in the body.  Keeping the breast implant mobile helps the capsule from becoming rigid.  On those occasions when we do get a call with a concern about capsular contracture, the first thing we ask is if the patient is still taking her vitamin E and doing her daily breast massage.  Overwhelmingly the answer is no.  While these practices are no guarantee, they do seem to help.

While capsular contracture may be one of the most common complications of breast augmentation that does not mean it happens often.  Good surgical techniques and smart follow up care help to reduce the risk of developing capsular contracture.  Most surgeons will have a low incident rate of capsular contracture in their patient population, but good surgeons can guide you through your options if capsular contracture does occur.