Capsular contractures are one of the most common causes for re-operation in breast augmentation surgery and can be problematic to deal with.
A capsule is a type of scar tissue that forms around an implant in the body. While we think of these in relation to breast implants only, they can actually occur with any type of implant that is used in medicine. Joint replacements, pumps and other devices—even cardiac pacemakers—can form capsules.
A capsule is not a problem when it is minor. A capsular contracture is a pathological condition that forms when the capsule becomes thickened and hard. They can range from minor contractures that present with just some discomfort around the breast to extreme cases where there is pain and distortion of the breast.
No one knows why capsular contracture occurs but there are some features that are known to be correlated. Silicone implants have a slightly higher incidence of this than saline implants but there are other factors that also are significant and affect the formation of a capsular contracture.
Infections and bacterial exposure to the implant can also cause them. The implant being placed sub glandular (what patients will refer to as “over the muscle”) compared with sub muscular (what patients refer to as a “under the muscle”) has a definite effect as well.
Other features have a more minor effect, such as avoiding a peri-areolar incision (incisions around the nipple-areola).
Dr. Arjang Yazdani, B.Sc., M.D., FRCSC
