Capsular Contracture Part Three: Treatment

By: Oscar Ochoa, MD

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Capsular contracture, once present, is a difficult problem to overcome.

The key to success for any treatment for capsular contracture is removing the source of inflammation. With that in mind, treatments that do not remove the affected capsule and implant will likely have a short-lived benefit.

The standard treatment of capsular contracture is capsulectomy, implant exchange and changing the location of the implant pocket. These techniques can be performed at the same time.

Capsulectomy is the partial or complete removal of the affected capsule. Because the implant may be contaminated during any additional surgery, implant exchange is also recommended. Changing the location of the implant pocket has also shown to be effective in decreasing contracture. For example, if the implant was previously located beneath the chest muscle, placement of the new implant above the muscle may decrease the chance of recurrence.

Use of acellular dermal matrix (ADM) along with capsulectomy can also effectively decrease the risk of contracture recurrence. ADM, in this setting, is used as a barrier between the implant and possible inflammation. However, this method is not the most common due to the higher costs for patients.

Breast cancer patients who have had radiation and choose implant reconstruction are also at a high risk for capsular contracture. This is due to the tissue damage caused by radiation treatments. The gold standard method for eliminating radiation induced capsular contracture is capsulectomy and replacement of the implant with the patient’s own tissue. Procedures like DIEP flap create soft natural appearing breast without the risk of further contracture complications.

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Learn More About DIEP Flap Breast Reconstruction

2 Comments

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  • ida terry

    Hello I am 8 weeks post explant due to one breast having a capsular contracture. It is very firm on the top and sits up high. The dr who removed told me he could not get all the capsule out but I am wondering is there anything I can do for this?  It is uncomfortable and painful. When I touch my breast it feels bruised. My outside surgical incisions have healed nicely and my other breast feels great and looks very natural. I did have radiation to that breast 3 years ago due to having cancer but since my surgeon told me he couldn’t get all the capsule out I am wondering if should I look into more surgery to try to remove some of the hardened capsule?


    Thank you
    Ida Terry

    Reply
    • PRMA

      Hello Ida! So sorry to hear you are experiencing this!  We would highly recommend seeking a second opinion from a board-certified plastic surgeon to review your needs.  It can be difficult to provide medical recommendations without an evaluation.  You are welcome to give our office a call to schedule an in-person consultation at 800-692-5565 or you can fill out our FREE virtual consultation form at https://prma-enhance.com/schedule-a-consultation/

      Reply
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