Understanding breast augmentation risks: capsular contracture

As the latest season of Love Island has come to end, it is interesting to note that a new survey has found that one in ten female viewers of the programme, aged between 18 and 34, had been left considering breast augmentation surgery. Breast enhancement with implants has always been a popular cosmetic surgery procedure with young women and it can produce fantastic, confidence-boosting results, but it is also essential that anyone contemplating this surgery are fully aware of all possible risks.

Any cosmetic surgery procedure entails a degree of risk as they are typically performed under a general anaesthetic and incisions will be made and tissues removed, reshaped or repositioned. There are also specific complications associated with a breast augmentation procedure and here we are going to focus on capsular contracture.

What is capsular contracture?

If an implant, such as a joint replacement or, in this case, a breast implant, is placed in the body, part of our natural healing process is to form a ‘capsule’ of scar tissue around the foreign body to ‘isolate’ it. This can help keep the breast implant in position and preserve shape, but in some breast augmentation patients the scar tissue can harden and contract around the soft, malleable implant.

This can result in changes to the aesthetic appearance of the breasts and, in some rare cases, discomfort and even pain. Research into the incidence of capsular contracture varies widely as not all patients display obvious symptoms, but in a 2016 review of literature published in the International Journal of Surgery Open, the authors noted that “although a range from zero to 50 percent has been noted, a more realistic incidence for capsular contracture, would be between 8 percent and 15 percent.”

How is capsular contracture diagnosed?

Diagnosis will usually be made by physical examination and your plastic surgeon will grade the degree of capsular contracture using a grading system. Grade one capsular contracture is asymptomatic which means it shows no symptoms and the breasts look natural and feel soft to touch. With grade two capsular contracture, there will usually only be minor symptoms and the breasts should still look normal but will feel firm to the touch.

For grade three capsular contracture, there will be more obvious aesthetic changes and the breasts may look overly round and the nipples may have also changed shape. The breasts will feel very firm to the touch, but it shouldn’t be causing any discomfort at that stage. Grade four is the most severe rating and the breasts feel very hard and will look misshapen. The breasts will often be sore and even painful to the touch.

What is the chance I’ll develop capsular contracture?

Generally, patients experience capsular contracture within the first two years post-surgery as it is a problem caused by the healing process. If you are experiencing capsular contracture symptoms many years later then your implants may have ruptured.

Genetics may play a role – if you have a family history of scarring problems or autoimmune disease, then you may have a slightly higher risk, but it is not really possible to predict who will develop capsular contracture.

How can capsular contracture be prevented?

While it is not possible to prevent capsular contracture from developing in every patient, there are ways that Mr Alan Park lowers the risk:

  • Minimal implant handling to prevent bacterial contamination
  • Choosing an implant size that is proportionate to your body, as overly large breast implants can stretch and thin the breast tissue, which can lead to a higher incidence of capsular contracture.
  • The use of textured gel implants – this has been shown to reduce the likelihood in comparison to smooth implants
  • Inserting the implants using an inframammary incision has been found to lower the risk compared to the periareolar or transaxillary approach
  • Placing the implant under the muscle – this can significantly reduce the risk
  • Gently massaging the breasts during the healing period may help prevent capsular contracture although this has not been proven and Mr Park will give you advice on when it is possible to start

If necessary, breast revision surgery can be performed and every step taken to prevent capsular contracture occurring again. For more information, call us on 01926 436341 to arrange a consultation.