Capsular contracture

Capsular Contracture

Capsular fibrosis around a breast implant.

Capsular contracture is a common complication associated with breast implants, where the scar tissue that naturally forms around the implant tightens and compresses the implant. This condition can lead to discomfort, aesthetic changes, and in some cases, the need for surgical intervention.

Pathophysiology

The body recognizes a breast implant as a foreign object and forms a fibrous capsule around it as part of the normal healing process. In some individuals, this capsule can become excessively thickened and contract, leading to capsular contracture. The exact cause of this excessive fibrotic response is not fully understood, but it is believed to involve a combination of immune response, bacterial contamination, and genetic predisposition.

Classification

Capsular contracture is often classified using the Baker scale, which ranges from Grade I to Grade IV:

• Grade I: The breast is normally soft and appears natural.
• Grade II: The breast is a little firm but appears normal.
• Grade III: The breast is firm and appears abnormal.
• Grade IV: The breast is hard, painful, and appears abnormal.

Symptoms

Symptoms of capsular contracture can include:

• Increased firmness of the breast
• Distortion of the breast shape
• Pain or discomfort
• Changes in breast position

Diagnosis

Diagnosis of capsular contracture is primarily clinical, based on physical examination and patient symptoms. Imaging studies such as ultrasound or magnetic resonance imaging (MRI) may be used to assess the condition of the implant and surrounding tissues.

Treatment

Treatment options for capsular contracture vary depending on the severity of the condition. They may include:

• Non-surgical options: Massage, medications such as leukotriene inhibitors, and external ultrasound therapy.
• Surgical options: Capsulectomy, capsulotomy, or implant replacement.

Prevention

Preventive measures may include:

• Using textured implants to reduce the risk of contracture
• Meticulous surgical technique to minimize bacterial contamination
• Post-operative massage and exercises

Related Pages

• Breast implant
• Fibrosis
• Plastic surgery