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Capsular Contracture Surgery

A capsule is the scar type tissue that develops  around any foreign body inserted into the body. The capsule is usually gossamer thin and supple and is is Nature’s  defence against any foreign material and protects you.

Capsular contracture, when the capsule surrounding a breast implant begins to hardens and tighten (contract) is a problem because it can distort the breast shape, cause pain and disrupt implant integrity. The diagnosis is clinical and does not require any special investigations. If there is concern that the underlying implant is leaking or ruptured then radiological investigation (MRI) may be required. Capsular contracture is the most common long term complication of breast implant surgery, occurring in 10-17% of patients with time (10-15years)

Capsule contracture is even more common after implant revision surgery

There are different levels, or grades, of capsular contracture. on the Baker scale.

Grade I: Breast is soft and natural in size and shape

Grade II: Breast is a moderately firmer than normal but looks natural to the untrained eye.

Grade III: Breast is firm to feel, with some distortion in size and shape. Sits tight, high and increasingly spherical.

Grade IV: Breast is firm, is distorted, and causing  pain.

Grades I and II do not require any surgical intervention. A Grade III or IV usually results in a need for surgery

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Capsular Contracture Surgery

At a glance

Treatment

Frequently asked questions

Capsular contracture surgery, requires concomitant removal or replacement of the implant since it is likely to be involved or microscopically damaged by the hardening and constriction of the capsule.  Two types of surgery are possible:-

A capsulotomy  – releasing incisions or holes in the capsule to create  soft, non-constrictive space around the new  implant. This is  a GA daycase procedure.

A capsulectomy,  may be partial, subtotal or total : This is the partial, subtotal or total removal of the capsule after the implant has been removed. Once any bleeding is controlled and the pocket washed out, a replacement implant can be inserted in to the same or a different plane. , removes the implant entirely from the capsule of scar tissue. The surgery can end there, if you don’t want a new implant. 

Alternatively, a new implant may be placed in a new pocket under the muscle (if it was originally over the muscle) or vice versa. The goal is to avoid bacterial contamination, which could lead to recurrent capsular contracture. A scaffolding material or acellular dermal matrix (a tissue graft) may be inserted around it, to provide support around the new implant.

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