ABC7’s The More in the Morning team spoke with Dr. Michael K. Kim, Board-Certified Plastic Surgeon, to discuss Capsular Contractures around breast implants. Capsular contracture is relatively rare but is a possible complication that can occur after breast augmentation with implants. Capsular contracture can affect women with either silicone or saline implants, though the incidence is slightly higher among patients with silicone gel breast implants. When an implant is placed, the body naturally forms a harmless capsule of scar tissue around the foreign body. A capsule around a breast implant can be of benefit. In most cases, the scar tissue remains soft and flexible. However, some capsules become overly firm and begin to squeeze the implant. This is referred to as capsular contracture.
If that capsule contracts or thickens, however, it can squeeze your implant. This contracture is what will cause pain, shifting, distortion, and hardening of the reconstructed breast. Typically, patients who develop capsular contracture notice the symptoms in the first several months – up to about two years – after surgery.
To treat Capsular contracture, both non-surgical and surgical options are available, and the best option depends on the severity of the contracture and your personal preference. However, prevention is the best "cure," and there are several things you can do to lower your risk of developing capsular contracture, such as massage, ultrasound, and medications may help the stiff capsule relax. These things can be done initially, as well as if it happens again after treating the initial contracture and surgery may not always be needed.
Baker Scale Grade
Capsular contracture may be barely noticeable or severe enough to greatly impact your quality of life. Capsular contracture is graded by the Baker scale and follows these criteria:
- Grade I: The breast is soft and appears normal, and the capsule is flexible.
- Grade II: The breast looks normal, but is somewhat hard to the touch.
- Grade III: The breast is hard and has some distortion caused by contracture, or instead, the breast may be significantly distorted, having a rounded shape or an implant that's tilted upward.
- Grade IV: Grade IV contractures look more advanced than grade III, often involving severe hardening of the capsule and pain.
If you develop stiff tissue around a breast implant, if the shape distorts, or if the implant wanders out of position, you can get help. A capsulectomy is surgery that removes the stiffened capsule, and the implant may be replaced during this procedure for best results, or to loosen the scar tissue by slicing it, allowing expansion.
Fat grafting has been a relatively recent addition to reconstruction options and has been used primarily to improve the cosmetic appearance and feel of the breast following reconstruction. While capsular contracture with breast implants can be less than ideal, there are treatments available. It's important to take steps before and right after surgery to reduce your risk of developing capsular contracture.