Breast augmentation is a commonly sought-after surgical procedure for enhancing breast size and shape. It’s important for individuals considering having breast implant surgery to be informed about potential complications that can arise. This guide focuses on two complications associated with breast augmentation: capsular contracture and implant issues.
Breast capsular contracture involves the tightening of scar tissue around the breast implant, leading to discomfort and breast distortion. Understanding its causes, signs, prevention, and treatment is crucial. Additionally, implant issues, including rupture, leakage, or displacement, can occur over time.
Knowing the causes, signs, prevention, and treatment options for these complications empowers individuals to make informed decisions regarding their breast health. Consulting with a qualified plastic surgeon is essential for personalised guidance in addressing these concerns.
Capsular contracture is an abnormal response of scar tissue that forms around breast implants, a common complication after breast augmentation. This scar tissue tightens and contracts, creating a firm and tight capsule around the implant. This can result in noticeable breast hardness, distortion in shape, and capsular contracture pain. It can affect the appearance, comfort, and lifespan of the breast implants. Early detection and timely treatment are essential to address this issue and prevent further complications.
Before delving into the causes and treatment of breast capsular contracture, it’s essential to differentiate between two related terms: capsular contraction and capsular contracture. These terms are often used interchangeably, but they refer to distinct phenomena.
In summary, a “capsule” represents the normal healing process, while “capsular contracture” is an abnormal and problematic response of the immune system, resulting in excessive scar tissue formation and tightening around the breast implant.
Several factors can contribute to the development of capsular contracture, including:
It’s crucial for individuals considering or having undergone breast augmentation surgery to be aware of these potential causes and take appropriate measures to minimise the risk of capsular contracture.
The severity of capsular contraction is categorised into grades 1 to 4.
Grade 1 (mild) and 2 (moderate): Treatment involves monitoring and conservative management. This could include techniques such as massage, medication, or other non-invasive methods to alleviate symptoms and prevent further progression.
Grade 3 (severe): Non-surgical treatments can often be used to attempt to provide relief. These treatments may include more aggressive massage, anti-inflammatory medications, or even ultrasound therapy.
Grade 4 (most severe): Significant breast distortion and discomfort means that revisional surgery is necessary for complete resolution. This surgical procedure typically involves removing the hardened breast implant capsule and replacing the implant. The surgeon may also consider changing the implant position or type to reduce the risk of future contracture.
Bacterial biofilm is a potential trigger. Bacteria can stick to the implant and cause inflammation. This inflammation can cause breast implant hardening also known as capsulated implant. To reduce this risk, it is important to prevent bacteria from forming around the implant.
Breast implant placement can significantly impact the risk of capsular contracture. The implant’s position affects how it interacts with the area around it and how much pressure is on the implant.
Infections that occur during or after breast augmentation surgery can potentially lead to capsular contracture. This infection can make the body create too much scar tissue around the implant.
Hematomas are when blood collects and builds up in that area. This can cause inflammation which can contribute to capsular contracture.
Genes can affect your immune response and whether you get capsular contracture. Your body’s reaction to the implants can be different from other people.
It’s important to note that in the initial stages, there may be no noticeable capsular contracture symptoms at first. Monitoring any changes in breast texture or shape and consulting with a healthcare professional if you have concerns is advisable to address the condition in its early stages.
It is important to be aware of changes in your body, which can include:
If you notice these symptoms of capsular contracture you should talk to a surgeon quickly so they can help.
The Baker Scale is a commonly used grading system for assessing the severity of capsular contracture
Grading involves assessing changes in the shape, feel, and mobility of the breasts, helping healthcare professionals determine the appropriate treatment approach based on the severity of the condition.
Dr Doyle aims to reduce capsular contracture occurring as a complication of surgery using the following techniques:
Correct implant placement is crucial to minimise the risk of complications in breast augmentation. Surgeons must carefully consider factors such as tissue coverage, patient anatomy, and implant size.
Submuscular placement, where the implant is positioned below the muscle, is often preferred as it can reduce the risk of capsular contracture and implant malposition. Partial under-the muscle placement results in an 8 -12% lifetime risk. This is opposed to 12-18%, with above the muscle implant placement.
Capsular contracture can be effectively treated through various approaches. It’s best to seek advice from an experienced plastic surgeon specialising in breast surgery.
The surgical removal of thick and hardened tissue around breast implants. This procedure is done to soften the look and feel of breast implants. You may choose to replace your implants at the time of surgery.
This procedure treats capsular contracture by removing the implant, followed by breast implant replacement. It’s essential to be aware that additional surgery to address capsular contracture may increase the risk of recurrent contracture, as it introduces new factors and potential complications.
Dr Mark Doyle advocates for the en bloc technique which is used during breast implant removal surgery and removes the implants and the scar capsule as a single unit. This approach aims to ensure that no residual scar tissue remains in the body, potentially reducing complications associated with capsular contracture and improving overall outcomes.
An emerging non-surgical option for capsular contracture involves multiple ultrasound sessions to enhance the elasticity of the breast capsule. Promising results have been reported, but it’s crucial to consult with a plastic surgeon before considering this treatment to assess its suitability for your specific situation and needs.
Complications with breast implants can arise following breast augmentation surgery, impacting the appearance, texture, and positioning of the implants. A frequent complication is breast implant malposition, characterised by improper placement or rotation of the implants.
Breast implant malposition pertains to the improper positioning of implants within the breast pocket, often involving implant rotations where the implant turns or shifts from its intended placement. Such malposition and rotations can result in issues like breast asymmetry, discomfort, and aesthetic concerns.
Malposition of breast implants can result from surgical technique errors, such as inaccuracies in creating the implant pocket. Additionally, factors like capsular contracture, trauma, and improper healing can contribute to implant malposition. Genetic factors, implant size, and the patient’s individual anatomy also play a role in influencing the risk of malposition.
Symptoms and visual changes associated with breast implant malposition include asymmetry, which results in uneven positioning of the breasts, as well as the visibility of implant edges or ripples. This can lead to the breasts appearing excessively high, low, or misshapen.
Surgical correction for breast implant malposition typically entails modifying the placement of the implant and adjusting the shape of the implant pocket. In some cases, correcting malposition may involve repositioning or replacing the implant. The primary goal of these procedures is to restore a natural and aesthetically pleasing breast symmetry.
There are 3 techniques to reduce your risk.
Breast augmentation recovery usually takes a few weeks to return to regular activities, with complete healing often taking several months. The timeline can vary based on individual factors and the surgical technique.
Breast implants may affect breastfeeding, with variables like surgical technique and implant type playing a role. It’s advisable to consult with your surgeon and a healthcare professional if you plan on breastfeeding with implants.
If you have any concerns or questions about complications with breast implants, please contact us. Our team can provide personalised advice and guide you through the best options for your situation.
Dr Mark Doyle is a Specialist Plastic Surgeon with over thirty years of experience performing Breast, Body, Face and Nose surgery. Dr Doyle is a fully qualified Specialist Plastic Surgeon with 30+ years of experience. He has completed all required training and only carries out approved surgical practices. There are absolutely NO undertrained doctors or cosmetic doctors acting as surgeons in our clinic.
As a highly esteemed plastic surgeon, Dr Mark is committed to achieving the best possible results for all his breast, body, face and nose patients, both men and women.