Breast capsular contracture implant-Capsular contracture - Wikipedia

Capsular contracture is a response of the immune system to foreign materials in the human body. The occurrence of capsular contraction follows the formation of capsules of tightly-woven collagen fibers, created by the immune response to the presence of foreign objects surgically installed to the human body, e. Capsular contracture occurs when the collagen-fiber capsule shrinks, tightens and compresses the breast implant, much like the collapse of a bubble gum bubble. Although the cause of capsular contracture is unknown, factors common to its incidence include bacterial contamination, rupture of the breast-implant shell, leakage of the silicone-gel filling, and hematoma. The degree of an incidence of capsular contracture is graded using the four-grade Baker scale:.

Breast capsular contracture implant

Breast capsular contracture implant

Breast capsular contracture implant

When the implant is removed with no implant replacement, a complete capsulectomy reduces the likelihood impplant a subsequent seroma because the raw tissue surfaces can heal and adhere properly to each other without the residual capsule in the way as a barrier. How does Aspen treat and reverse capsular contracture? A long-term study of outcomes, complications, and patient satisfaction with breast implants. Baker Breast capsular contracture implant Grade. If you're a good Breast capsular contracture implant for Aspen therapy, this pain-free procedure can treat and reverse capsular cintracture. This suggests that a submuscular placement should be favoured over a subglandular placement in order to reduce future complications.

Cat girl ass. What causes capsular contracture?

About 75 percent of capsules occur within the first two years following surgery. In Breast capsular contracture implant past, the treatment options available for breast augmentation patients with capsular contracture left Breast capsular contracture implant to be desired. Additionally, everyone's immune system responds differently to stimuli, and some patients' immune systems react poorly to Celebrity skating winner implants. The placement of implants is also being evaluated relative to the tendency to develop contractures. The breasts will usually appear normal in shape but feel somewhat Breast capsular contracture implant to the touch. You should never disturb the tissue of your Breast capsular contracture implant while they are healing from surgery without first getting permission from your surgeon. Capsules actually form around every breast implant, silicone or saline. If firm, high riding breasts occur, however, a lot of extra scar tissue has formed and surgical intervention is required to either cut and release the contraction Capsulotomyor cut out and remove the capsule Capsulectomy. Choose a board-certified plastic surgeon and Myspace asian art confident you are in the care of a highly-trained surgeon you can trust. Related Posts. Thanks for your feedback! The following considerations will therefore also be taken by Dr. Interestingly, those who present with effusion with or without capsular contracture have a better prognosis than those presenting with a mass [ 90 ]. In animal studies and small patient populations, this has been shown to have a positive effect.

After breast augmentation surgery, your immune system will respond to the foreign materials inserted into your chest.

  • Once a breast implant is in place, fibrous scar tissue forms around it, creating a tissue capsule.
  • As a result, the breast may feel painful and stiff, and the capsule may affect the appearance or shape of the breast.
  • Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence.

Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body the implant and has an overall incidence of Risk factors that were identified included the use of smooth vs. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy.

However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants.

Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer. This commonly involves an implant being inserted within the breast in order to alter the shape and size of the breast. Various types of implant are available and they are generally divided according to the shape of the implant whether rounded or anatomically shaped , or the surface texture whether smooth or textured or the gel used to fill the implant usually either saline or silicone [ 2 ].

These can take one of two forms: a silicone outer shell with a silicone gel filling, or a silicone outer shell with an alternative filling, such as saline [ 3 ]. As with any surgery, implant based breast augmentation has been associated with a number of risks and complications. Introduction of non-biologic materials into the body always induces formation of a capsule, but in the breast this may be particularly severe.

Capsular contracture is a local complication thought to occur due to an excessive fibrotic foreign body reaction to the implant. It is thought to be an inflammatory reaction which causes fibrosis through the production of collagen [ 3 ], leading to excessively firm and painful breasts [ 6 ].

If severe enough, this can require reoperation [ 7 ]. For an example of how capsular contracture may present Fig. This is a picture of a year-old woman who has Baker grade IV capsular contracture. On the left, the breast is noticeably higher and there is noticeable skin puckering along the medial side. The nipple is higher relative to the right side. Capsular contracture is traditionally classified using the Baker classification system, a subjective classification system that is based upon clinical findings in the patient by the physician.

It is divided into four classes: I and II are not clinically significant, in that I describes a breast that looks and feels absolutely natural and II describes a breast with minimal contracture in that the surgeon can tell surgery has been performed but there are no symptoms.

Class III and IV are clinically significant and symptomatic, with III describing moderate contracture with some firmness felt by the patient and IV describing severe contracture which is obvious from observation and symptomatic in the patient [ 8 ]. Individual studies have published incidence rates of capsular contracture ranging from 2.

A recent systematic review published a combined overall rate of 3. However, there is a wide range of heterogeneity between studies in terms of follow up times which may affect capsular contracture development rates, as well as a lack of standardisation in the type of implant and surgical techniques used.

The individual study variables are outlined in Table 1. Despite this, the aetiology and pathogenesis is not yet clear, although it appears to be multifactorial. In order to effectively treat, or even prevent capsular contracture, it is important to understand the mechanisms that lead to it. The aim of this paper is to review the current literature available in order to look at the pathogenesis, the risk factors and the optimal management of capsular contracture following breast augmentation surgery.

The pathogenesis of capsular contracture is thought to be multifactorial. It is known that capsular contracture is essentially an excessive fibrotic foreign body reaction that occurs after implantation [ 6 , 15 ]. Whist on the one hand, this fibrotic reaction helps to maintain the position of the implant, if excessive it can lead to pain and deformity of the breast [ 16 ].

Macrophages, lymphocytes and fibroblasts have been reported to be the predominant cell types within the capsule. As fibroblasts produce collagen, they have been linked to the initial formation of the capsule.

Histological evaluation of capsular tissue has shown that the majority of the tissue is made up of uniformly distributed collagen fibres [ 3 , 19 ]. The orientation and organisation of the collagen fibres appears to change as contracture severity worsens: the fibres become thicker and establish themselves in cable-like bundles which orientate themselves perpendicular to the fibroblasts to produce a helical orientation as the severity increases [ 20 ].

The fibroblasts in turn orientate themselves planarly when studied in capsules surrounding smooth implants [ 16 ]. Mast cells have also been investigated with regards to their involvement in the pathogenesis of capsular contracture. Additionally, capsular fibroblasts express corresponding receptors, indicating that the mast cells may activate neighbouring fibroblasts via a paracrine pathway following mast cell degranulation, leading to increased production of collagen and therefore development of capsule contracture.

The role of myofibroblasts in the development of capsule contracture has also been investigated. Myofibroblasts are contractile fibroblasts which are thought to provide a contractile force which decreases the surface area of the capsule whilst the collagen matrix remodels and stabilises the contracture.

In the same study, Persichetti et al. Therefore, anti-oestrogenic therapy may help reduce the severity or perhaps prevent capsular contraction from developing.

A role of T cells has also been hypothesised. Despite knowing the cells that appear to involved in the process of capsular contracture, it is important to know the way in which they are activated in order to understand how exactly it develops and thus develop strategies to try and prevent it. A recent study by Katzel et al.

Other immunological agents have also been reported as having a role in the development of capsular contracture. These include connective tissue growth factor factor and interleukins 4, 6, 10, 13, and 21 amongst others, all of which promote fibrosis [ 30 ].

Interleukin-8 has been suggested as a potential biomarker after Kyle et al. This is not the only molecule that has been discussed as a potential biomarker. Wolfram et al. Although the majority of current evidence appears to support the role of the immune system, historically it has been suggested that capsular contracture may result from an exaggerated inflammatory response caused by a haematoma or infection.

A number of studies have found that the presence of bacteria accelerates contracture development in animal models [ 33 , 34 ]. In particular, the role of coagulase negative staphylococcus species has been investigated with some interest, with a lot of focus on involvement of Staphylococcus epidermidis , where its presence on implants in animal models has been found to cause increased capsule pressure and a thicker capsule that has an increased density of collagen and increased angiogenesis, all of which are subsequently associated with capsular contracture [ 33 ].

However, this theory fails to take into account a number of variables. Firstly, capsular contracture does not affect every patient; therefore it is likely that phenotype plays a part in the reaction.

Also, this theory fails to take into account the time lapse often present between surgery and clinically significant contracture development, which can vary greatly. Additionally, prophylactic strategies such as antibiotic irrigation have failed to show any difference in capsular contracture rates, with reports that washing the implants antispetcially or giving systemic antibiotics having only minor effects, if any [ 16 ].

In one study, triple antibiotic breast irrigation was found not to be associated with a significant reduction in the severity of capsular contracture, with rates published at 3.

Additionally, in a porcine experiment, animals which were given implants and inoculated with S. This indicates that infection, and the subsequent inflammatory response, whilst maybe increasing the rate at which capsular contracture develops does not in fact cause it. There is a wide variety of implants that are available for implant based breast surgery, each of which have slightly different properties. These can be broadly separated into whether the surface of the implant is smooth or textured, or whether they are filled with silicone gel or saline and whether the implants are rounded or anatomically shaped.

Patients tend to be consulted on the type of implant they would prefer, be that silicone based or saline based, so therefore it is important to understand the risks associated with each in order to allow fully informed consent. Silicone gel implants, first introduced in , currently dominate the world market and this is reflected in the much larger range available for use [ 36 ]. In the past, there were concerns with the use of silicone gel implants, especially in the United States of America where their use was restricted to clinical trials up until due to safety concerns.

However, long term studies assessing their safety are currently underway. In terms of the Allergan models, there is both rounded and shaped implants available. A long term multicentre clinical trial is currently underway assessing the Natrelle Style implant, a form stable highly cohesive shaped model. A further study reported a 5.

A similar study looking at shaped Mentor silicone implants reported a 2. However, saline is still an option for patients. There is less variety available with saline implants and they have remained relatively unchanged over the last few years. In terms of capsular contracture risk, a ten year prospective study of the Allergan Natrelle saline filled implants found a This is in contract to a meta-analysis carried out in which reported a greater than two-fold increased risk of capsular contracture following treatment with silicone gel implants as opposed to saline.

The surface texture of the implant has also been found to have an effect on the incidence of capsular contracture. In terms of the surface of the implant, it has been established that textured implants are associated with a lower risk of clinically significant capsular contracture. A randomised controlled trial found that, with submuscular placement of the implant, patients had reduced symptoms of contracture when a textured implant was used [ 48 ]. This finding was supported by a recent risk analysis, which concluded that smooth implants resulted in increased odds of capsular contracture [ 49 ].

A systematic review concurred, showing that using textured implants resulted in the number needed to treat was 8. Implants with a macrotextured surface were found to significantly decrease the risk of capsule contracture in particular, with participants in one particular study finding that when such implants were used, the capsule mimicked the feeling of natural breast firmness [ 50 ]. However, the overall higher incidence rate found with smooth implants suggests that biofilm production may not in fact play a large part in capsular contracture development.

Textured implants may be associated with a lower incidence of capsular contracture because of the way in which they interact with the surrounding tissue. The textured surface is thought to disrupt the contractile forces around the implant [ 16 ]. Animal studies have found that use of smooth implants led to thicker capsules with an increased concentration of collagen fibres, and additionally had a higher concentration of thick fibres [ 52 ].

However, it may appear that aggressively textured implants may be associated with other problems, with one study finding a link between the use of textured implants and double capsule formation, which was not seen with smooth implant use [ 53 ].

Polyurethane coated breast implants provide a textured outer surface and have been researched recently due to the reported associated low capsular contracture incidence rates. A recent study by Pompei et al. They found that capsular contracture occurred in 6. Older studies have also found low incidences of capsular contracture.

The authors hypothesised that this low rate was due to breakdown of the polyurethane coating causing remnants of the material to be retained within the capsule causing the collagen fibres to interweave. Histological examination has also found that in capsules surrounding polyurethane implants, there is less fibrotic tissue and less type 3 collagen than seen with textured implants [ 56 ].

Decisions regarding the procedure have been shown to have an effect on the incidence of capsular contracture. It is commonly accepted that a submuscular placement, where the implant is placed behind the pectoralis major muscle, leads to a lower incidence of capsular contracture than when the implant is placed just under the skin, in a subglandular placement subglandular [ 14 , 49 , 57 ].

However, both placements can still lead to contraction. Siggelkow et al. A recent systematic review found that overall rates of capsular contracture with subglandular placement stood at 8. However, these findings are not universal, with some studies finding no difference between anatomical pocket location and rates of capsule contracture [ 12 ].

Siggelkow et al. There is less variety available with saline implants and they have remained relatively unchanged over the last few years. Implants with a macrotextured surface were found to significantly decrease the risk of capsule contracture in particular, with participants in one particular study finding that when such implants were used, the capsule mimicked the feeling of natural breast firmness [ 50 ]. Discuss these and other options for avoiding capsular contracture with your plastic surgeon prior to your breast augmentation surgery. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. Choose a board-certified plastic surgeon and be confident you are in the care of a highly-trained surgeon you can trust. By using Verywell Health, you accept our.

Breast capsular contracture implant

Breast capsular contracture implant

Breast capsular contracture implant

Breast capsular contracture implant

Breast capsular contracture implant

Breast capsular contracture implant. What is capsular contracture?

Jugenburg changes gloves and coats the new gloves and instruments with antibiotic solution. The breast pocket is then also washed with antibiotics solution.

Next, Dr. Jugenburg places the implant into the breast pocket, touching it only with gloves and instruments covered with antibiotic solution. Neither air nor skin bacteria are allowed to touch the implant. The rare patient also develops repeated Capsular Contracture, but in the majority of cases it can be successfully treated.

Such methods include breast implant massage , ultrasound, pulsed electromagnetic field, and leukotriene pathway inhibitors Accolate, Singulair. When non-surgical methods fail, surgery is used to release the tightened capsule. Under sterile conditions, the breast pocket is opened, the implant is removed, and the capsule is either cut multiple times to release the contraction Open Capsulotomy , or cut out and removed Open Capsulectomy before replacing the implant.

An Open Capsulotomyis normally the first line of defense and works in the majority of cases; it can be performed through the underarm and the recovery time is typically 1 — 2 days. Anyone can develop Capsular contracture, but it is statistically unlikely. At Toronto Cosmetic Surgery Institute, we take every possible step during surgery to further minimize your risk.

These steps include: meticulous efforts to stop all bleeding at the time of surgery and the use of absolute sterile conditions. Scarring inside your breasts cannot be predicted by past scarring from injuries or by your family history; it is truly a random occurrence. However, at the Toronto Cosmetic Surgery Institute, we take a number of steps to minimize your risk.

Post-surgical breast implant massage may help by encouraging the body to form a scar capsule slightly larger than the implant itself, and thereby having a softer feel. Vigorous massage may also help prevent the continued formation of an unacceptable Capsular Contracture. Further information on breast implant massage is given here.

Any patient could develop Capsular Contracture at any time. After healing from Breast Augmentation surgery, your breasts should feel soft and natural. Over time, your breasts may become slightly firmer, but still remain soft. If there is severe hardening, then Capsular Contracture may be happening. If these symptoms are allowed to progress, it can eventually become painful. You should be evaluated as soon as possible. Jugenburg if they feel that their implants may be becoming abnormally firm.

At Toronto Cosmetic Surgery Institute, this is done by carefully minimizing risk factors during Breast Augmentation surgery and by all patients performing breast implant massage exercises after their surgery. Patients rarely develop Capsular Contracture that is serious enough to require surgery. If firm, high riding breasts occur, however, a lot of extra scar tissue has formed and surgical intervention is required to either cut and release the contraction Capsulotomy , or cut out and remove the capsule Capsulectomy.

Capsular Contracture alone does not cause implant rupture; the contraction force is exerted evenly around the surface of the implant. Capsular Contracture in Breast Implants All implants and implanted devices in the body create a normal immune response where a capsule of protective scar tissue collagen fibres forms to envelope the implant.

What is Capsular Contracture? Grade I — the breast is normally soft and appears natural in size and shape Grade II — the breast is a little firm, but appears normal Grade III — the breast is firm and appears abnormal, there is no pain Grade IV — the breast is hard, painful to the touch, and appears abnormal What Causes Capsular Contracture? The following have been found to be factors that increase the risk of Capsular Contracture occurring: Above muscle placement vs.

Breast Fold incision Peri-areolar incision vs. How Dr. Jugenburg Minimizes the risk of Capsular Contracture Formation At the Toronto Cosmetic Surgery Institute, we are meticulous in our approach towards minimizing your risk of developing Capsular Contracture and in achieving the perfect, worry-free breast enlargement for you.

The following steps are taken during surgery: To minimize the risk of contamination, we use absolutely strict sterility measures during Breast Augmentation surgeries. All implants are also washed with an antiseptic solution prior to insertion under your breasts. All these measure reinforce our efforts to ensure absolute sterility of each and every procedure.

To minimize the risk of bleeding, Dr. In animal studies and small patient populations, this has been shown to have a positive effect. The authors hypothesised that this could lead to a reduction in contracture. Similarly, in a patient study which used acellular dermal matrices to prevent capsular contracture, no patients in the preventative group developed capsular contracture, leading them to conclude that its use significantly lowers the incidence of capsular contracture in the first 3.

When used as a treatment for established capsular contracture, complete acellular dermal matrix coverage has been found to be an effective management strategy in grade III to IV capsular contracture, with no recurrence being seen at a follow up of 9. Again, like with other proposed management strategies, long term studies are needed in a patient population in order to establish if acellular dermal matrices do in fact prevent capsular contracture, or if they simply delay its onset.

Although the exact eitopathogenesis of capsular contracture remains to be discerned, the inflammatory response seems to have a role. Therefore, it is thought that altering the inflammatory response through medication may reduce the incidence of capsular contracture.

A number of studies have also been carried out in women who have undergone implant based surgery. Generally speaking, although many of the studies have found a reduction in the Baker grading of capsular contraction with a dose of 20 mg twice a day taken orally [ 77 , 78 , 79 , 80 , 81 ], however, there was no literature found in patients where Zafirlukast was used as a preventative measure, which may be useful to look at in the future.

Mammary compliance was assessed before treatment and then monthly up to a year after cessation of treatment. Interestingly, whilst patients were actively taking treatment, contracture grading scores decreased however, on cessation of treatment, grading began to increase again [ 81 ], indicating that in order to have a long term effect patients would have to continue taking the drug, which could then lead to problems with side effects such as adverse effects on the liver.

An earlier study suggested that the beneficial effects of Zafirlukast may be maintained for longer, finding that The majority of breasts in this study had mild contracture, with Botulinium toxin A has been reported to be effective at reducing keloid scarring.

Implant capsules have been found to be histologically similar, so it has recently been investigated to see if it can reduce the amount of contracture or prevent its development. A study in rats which involved injected 0. A study in rats that looked at the use of AABS and compared to a control group and to a fibrin treated group found that, in treatment groups, there were thinner capsules and significantly decreased amount of type 1 collagen compared to controls, but that there was no significant difference between the AABS group and the fibrin treated group [ 84 ].

Another risk associated with the use of implants is the possibility of anaplastic large cell lymphoma ALCL. A recent review concluded that there was a relative risk of These figures are yet to be confirmed with further studies, and it is possible that they may change in light of updated numbers of case reports and increased global awareness of the disease. The overall incidence is quite low, estimated to be 1 in 1 million per year [ 89 ], however women who develop this condition may present with capsular contracture and an effusion within the capsule.

Alternatively, women may also present with an effusion and a mass lesion. Interestingly, those who present with effusion with or without capsular contracture have a better prognosis than those presenting with a mass [ 90 ].

Recurrent capsule contracture has been identified as a possible independent presenting symptom in those with ALCL, and possibly capsular contracture occurring years after the first surgery which appears to refractory to usual management techniques [ 91 ].

This should be borne in mind when assessing a patient with capsular contracture, as earlier treatment may lead to a better prognosis. These are microphotographs showing the appearance of anaplastic large cell lymphoma in the capsule surrounding an implant. Pleomorphic cells with anaplastic nuclei and prominent nucleoli can be seen. This literature review has attempted to outline some of the recent research regarding capsular contracture after breast augmentation surgery in order to identify risk factors and potential management strategies.

From the current literature, it would appear that capsular contracture is a multifactorial process which involves inflammatory processes which then cause a fibrotic reaction in the tissue surrounding the implant, although the precise trigger and the reason why this happens is still not clear. Despite this, risk factors have been identified. From the currently available research, it appears that smooth implants, paced in a subglandular position have the biggest risk of developing capsular contracture.

Medical treatment of symptomatic cases seems to be ineffective and surgical therapy is associated with a significant rate of recurrence. However, there is a flurry of promising new research attempting to elucidate new management strategies or prophylactic strategies attempting to stop capsular contracture before it begins. In addition, new strategies for preventing and treating capsular contracture need to be evaluated in large patient population studies in order to evaluate their real life benefits.

Due to findings that the immune system is involved in the pathogenesis, future research should also focus on the possibility of biological profiling in order to identify women at an increased risk of capsular contraction and therefore offer them the best possible treatment with the lowest possible risk.

No potential conflict of interest relevant to this article was reported. National Center for Biotechnology Information , U. Journal List Arch Plast Surg v. Arch Plast Surg.

Published online Sep Find articles by Hannah Headon. Find articles by Adbul Kasem. Find articles by Kefah Mokbel. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Correspondence: Kefah Mokbel. This article has been cited by other articles in PMC. Keywords: Capsular contracture, Breast implants, Mammoplasty.

Open in a separate window. Table 1 A table showing the individually reported incidence rates for capsular contracture following implant based breast augmentation surgery. Surgical technique Decisions regarding the procedure have been shown to have an effect on the incidence of capsular contracture. Medical methods Although the exact eitopathogenesis of capsular contracture remains to be discerned, the inflammatory response seems to have a role.

Atypical large cell lymphoma complicating augmentation mammoplasty These are microphotographs showing the appearance of anaplastic large cell lymphoma in the capsule surrounding an implant. Footnotes No potential conflict of interest relevant to this article was reported. References 1. Johnson M. Breast implants: history, safety, and imaging.

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T regulatory cells and TH17 cells in peri-silicone implant capsular fibrosis. Monocyte-dependent stimulation of human T cells by silicon dioxide. Silicone-specific blood lymphocyte response in women with silicone breast implants. Clin Diagn Lab Immunol. Matrix metalloproteinases, tissue inhibitors of metalloproteinases, aminoterminal propeptide of procollagen type III, and hyaluronan in sera and tissue of patients with capsular contracture after augmentation with Trilucent breast implants.

The impact of Smad3 loss of function on TGF-beta signaling and radiation-induced capsular contracture. Tamoxifen decreases fibroblast function and downregulates TGF beta2 in dupuytren's affected palmar fascia.

J Surg Res. Effect of tamoxifen on transforming growth factor beta1 production by keloid and fetal fibroblasts. Arch Facial Plast Surg. Effects of fibrin, thrombin, and blood on breast capsule formation in a preclinical model. Identification of molecular phenotypic descriptors of breast capsular contracture formation using informatics analysis of the whole genome transcriptome.

Wound Repair Regen. Altered systemic serologic parameters in patients with silicone mammary implants. Immunol Lett. Effects of coagulase-negative staphylococci and fibrin on breast capsule formation in a rabbit model. Subclinical biofilm infection causes capsular contracture in a porcine model following augmentation mammaplasty. Plast Reconstr Surg Glob Open. Breast implants: saline or silicone? Style cohesive silicone breast implants: safety and effectiveness at 5 to 9 years after implantation.

Cunningham B. Mentor Contour Profile Gel implants: clinical outcomes at 6 years. Natrelle saline-filled breast implants: a prospective year study. Incidence of capsular contracture in silicone versus saline cosmetic augmentation mammoplasty: a meta-analysis.

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Hakelius L, Ohlsen L. A clinical comparison of the tendency to capsular contracture between smooth and textured gel-filled silicone mammary implants. Capsular contracture with breast implants in the cosmetic patient: saline versus silicone--a systematic review of the literature. Does the surface structure of implants have an impact on the formation of a capsular contracture?

Risk factor analysis for capsular contracture: a 5-year Sientra study analysis using round, smooth, and textured implants for breast augmentation. How texture-inducing contraction vectors affect the fibrous capsule shrinkage around breasts implants? In vitro and in vivo investigation of the influence of implant surface on the formation of bacterial biofilm in mammary implants.

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How to Avoid Capsular Contracture | Jonathan Hall, MD, FACS

After breast augmentation surgery, your immune system will respond to the foreign materials inserted into your chest. The capsule is made from interwoven collagen fibers, or scar tissue. This tightening can squeeze the implant, making it feel hard and painful to touch. To help prevent this from happening, your plastic surgeon will likely recommend that you perform a daily breast massage in the first few months after your surgery. Massage can help prevent the capsule from hardening, but it may not stop the process completely.

After your surgery, your surgeon will advise you on how to massage the area. They may also refer you to instructional videos describing the proper technique.

If your doctor does perform your breast massage, they could lose their medical license. Talk to your doctor about when you should start your massage therapy. This can vary depending on your individual surgery. Some practitioners recommend that you start a daily routine a week or so after surgery. Make sure you talk to your doctor about how to safely massage the area.

Some practitioners recommend that you vigorously massage your breasts:. Although the recommendations for how often and how long to massage can vary, doctors typically agree that regular breast massage is one of the best ways to prevent capsular contracture.

Ideally, you will watch an instructional video during your appointment to help guide you or receive an instructional diagram before you leave. Anti-asthma medications may help soften the capsule. Vitamin E may also be beneficial.

Talk with your doctor before you take any medications or supplements. They can walk you through your options and discuss any potential benefits or risks. In some cases, surgery may be an option. Talk to your doctor about whether this is the best route for you. With capsulectomy, the entire capsule is removed and the implant is replaced. Although everyone who undergoes breast augmentation will develop a capsule — which is how your body naturally responds to having an implant — not everyone will develop capsular contracture.

Researchers in one meta-analysis estimated that capsular contracture affects between 15 to 45 percent of women who undergo breast augmentation. The type of implant used may also be a factor. Smooth implants may have slightly higher risk for capsular contracture than textured implants do.

Saline implants may carry a lower risk than silicone implants. You should massage your breasts for 5 minutes two to three times a day during the first two months after surgery. A receding hairline can start to develop in people as they age. In many cases, hair loss, or alopecia, can be treated with surgery or medications. During a hair transplant, a surgeon moves hair from a hair-filled section of the head to a bald area.

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Can a doctor help? Massage technique Risks and warnings Other treatment options Is this likely? Outlook Does massage help capsular contracture? Can you see a doctor for therapeutic massage for capsular contracture? What massage technique to use?

Are there any risks and warnings? Are there other treatment options? Will everyone with breast implant develop capsular contracture? What is the outlook? Varicose Veins: Causes, Symptoms, and Diagnosis. Read this next.

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Breast capsular contracture implant