Q) Is this a capsular contracture?

A) Many are aware of the highly problematic side effect of breast augmentation, capsular contracture. Also, they want to find out if the capsular contracture has been developed or not.




The reason the many patients ask about the capsular contracture is because these patients are curious about how much their augmented breasts look and feel original. If a patient touches her breast and feels not normal, then she might think “do I have a side effect?”.

You would feel that the breast with the capsular contracture looks unnatural and round like a football. This is how it got its name. Medically called ‘Capsular Contracture’, it is a formation of hard capsule of epithelium around the breast implant.

 
Then, what is an epithelium? You need to understand this in order to understand capsular contracture.

Epithelium is a scar tissue formed when a foreign substance enter the human body. If a bullet penetrates and gets into the body, a thick and rough capsule surrounding the bullet will be formed. Silicone implant, too, is a foreign substance, therefore, the body produces a capsule to separate itself from the implant. This is an epithelium.



Can one avoid the formation of the epithelium? No, one cannot. It must be formed. If the epithelium is not formed, then you do not have a proper level of immunity.

There is a commonly used scale for the capsular contracture.

Grade 1 ; The breast feels soft and looks normal
Grade 2 ; The breast is a little hard, but normal
Grade 3 ; The breast is firm and is there is asymmetrically distortion of shape
Grade 4 ; The breast is hard and the shape distortion is severe (with pain)

This scale is not scientific.

The words ‘firm’ and 'hard’ are subjective.

Therefore, the question “is this a capsular contracture?” and the answer “yes it is” or “no it isn’t” are also subjective.



One can check for the thickness of the epithelium through the ultrasound test, but there is no standard on what is normal or not according to the thickness.


The diagnosis of the capsular contracture is depended on how the doctor and the patient feels and comes to a conclusion.

If the doctor touches the breast and feels that the liquidity and the softness are not normal, then this could be a capsular contracture. If the patient feels that her breast is really hard and is unsatisfied with it, then she could consider that this is a capsular contracture.

But it would be difficult to base judgment according to how one’s breast feels compared to her friends or neighbors.





Although there is no accurate scale, one should consider the average and the standard deviation numbers and see if the data is on the abnormal side or not.

It becomes more difficult when we talk about the treatment procedures. (There are certain uncertainties)

It leads to an uncomfortable situation if the doctor thinks that one should wait but the patient wants to get treated with correction surgery. The same applies if the doctor recommends the correction but the patient refuses.


In reality, the doctor and the patient need to come to an agreement. Much communication is necessary.

What are some ways that one can avoid the capsular contracture?

We still do not know what causes the capsular contracture (no biochemical cause has been found), therefore, we do not have one answer in how to avoid it.




There could be additional incision, removal of the scar capsule, removal of the implant and making a secondary placement, etc to treat capsular contracture. Most of these methods are successful.

I try to minimize the penetration of the foreign substance and also minimize the damage on the tissue cells to avoid capsular contracture when conducting the breast augmentation.

Today, I posted about the capsular contracture. Thank you for reading. Have a great day.