Breast Augmentation: Cost, Reviews, Photos

After a period of time usually years rather than months the breasts may begin to feel hardened and look distorted.

These are the early signs of capsular contracture after breast augmentation which are classified into 4 grades.

The treatment for this problem is to remove the implant and its surrounding capsule and replace with a new implant. (Robert M. Grenley, MD, Seattle Plastic Surgeon)

Capsular contracture is classified during physical exam by a plastic surgeon.

You may also be experiencing syptoms that may be related. Sometime an MRI can also detect excessive scar tissue around the implant. I would advise you consult with a board certified plastic surgeon to be examined. (Kurtis Martin, MD, Cincinnati Plastic Surgeon)

Classification of capsule contracture

Progressiively firmer breasts 10 years after a breast augmentation is suggestive of capsule contracture. Classifying capsule contracture is done through history and physical examination only.

No diagnostic tests are needed or helpful. There is classification of capsule contractures:

1. Breasts feel firmer but look normal/the same

2. Breasts feel firmer and the shape and contour of the breasts have changed

3. Breasts feel firmer, shape has changed, and there is pain/discomfort. (Kurtis Martin, MD, Cincinnati Plastic Surgeon)

Capsuluar contracture varies in severity. If your breast feel very hard and they are painful with manipulation, then you most likely have capsular contracture after breast augmentation. You need to be evaluated by a Board certified plastic surgoen and consider capsulectomy and exchange of breast impalnts. (Michael Vennemeyer, MD, Southlake Plastic Surgeon)

Capsular Contracture after Breast Augmentation

Hardness, tightness, firmness, and a distorted appearance are all signs of capsular contracture after breast augmentation surgery. In order to diagnose capsular contracture, your plastic surgeon will perform a physical exam and get an imaging study.

MRI is the most sensitive study, but ultrasound can also be used to aid in diagnosis. If you have capsular contracture, you will likely require an operation to perform a capsulectomy and replacement of your breast implant. I suggest you see your plastic surgeon for an in-person consultation. (Alfred Sofer, MD, FACS, Fairfield Plastic Surgeon)

Do I have a capsular contracture after breast augmentation ?

You are describing what sounds like a possible capsular contracture on both breasts.This is a development of increased scar tissue formation surrounding the implant. It can lead to firmness, and also associated distortion of the breasts shape. Pain can be one of the advanced signs. This phenomenon is classified by severity (Baker Classification).

The treatment is a capsulectomy procedure (removal of the thickened breast capsule). If one is to keep the implants, then new implants are placed. If the original position is above the muscle, then a consideration of repositioning them in the submuscular pocket may be helpful in deterring a recurrence. In some studies the recurrance rate can be up to 50 percent. (Lara Devgan, MD, MPH, New York Plastic Surgeon)

Capsular contracture (CC) is a much less common occurrence than it used to be due to better implants, sub-muscular positioning of the implants, meticulous aseptic technique and better understanding of the cause of CC.

When it does occur, there is a range of signs and symptoms. At the worst, the breasts can become hard and tender with the implant become distorted into a round and superiorly displaced position.

If this occurs, it is generally the result of a mild subclinical infection which caused the body to “recognize” the implant and wall it off, or possibly from a leak, in the case of a silicone implant. Regardless of the cause, you should consult with your plastic surgeon as re-operation may be necessary. (Bryan Correa, MD, The Woodlands Plastic Surgeon)

Capsular contracture versus breast thinning

As you age, your breasts change and may thin out depending on your genetics, the size of your implants and other factors. You may have abnormal hardening of the scar tissue around your implants as others have discussed below (a capsular contracture rated 1-4) or thinning of your breast tissue or both. A detailed history and physical exam by a board certified plastic surgeon would be used to answer your question. Most likely, no surgery is indicated. If things progress, surgery may be required to improve your condition. (Lara Devgan, MD, MPH, New York Plastic Surgeon)

How do I tell if I’m having breast implant capsular contracture?

Every breast implant forms a capsule; this is the body’s normal response to having an implant present. Breast implant capsular contracture refers to this capsule becoming thicker and tighter leading to firmness, distortion, or discomfort. Your plastic surgeon diagnoses capsular contracture based upon a physical exam and your history.

I would recommend getting an evaluation by a plastic surgeon to discuss in greater detail the problem you are experiencing and whether or not anything needs to be done about it. (Sergio P. Maggi, MD, Austin Plastic Surgeon)

Capsular Contracture Classification

It’s a great question. The body naturally forms a capsule around all breast implants. In some patients this capsule becomes thickened and can tighten. This can cause the breast to feel firm, look abnormal, or become painful.

It is thought that the presence of bacteria, or blood, within the breast pocket can cause a abnormally thick capsule to form. There is classification of capsular contracture.

Grade I — the breast is normally soft and appears natural in size and shape.

Grade II — the breast is a slightly more firm, but has a normal appearance.

Grade III — the breast is firm and appears distorted.

Grade IV — the breast is hard, painful, and appears abnormal.

After breast augmentation, a small group of patients will notice that one or both sides begin to harden. It’s possible to determine if you have a capsular contracture by consulting with your surgeon, or noticing that one side feels more firm than the other.

It’s important to take precautionary steps in the operating room to address the causes of capsular contracture. This includes keeping the pocket dry by using meticulous hemostasis. Using a “no touch” technique when handling the implant. This involves using a Keller funnel.

A Keller funnel allows the surgeon to place the implant without touching it. The implant is also rinsed in antibiotic solution before it is placed. With all of these precautions the capsule contracture rate should be relatively low. (Matthew H. Conrad, MD, Wichita Plastic Surgeon)

Detecting capsular contracture

Breast implant capsular contracture results from the formation of a thick tissue layer (the capsule) around the implants rather than a problem with the implants themselves.

Early symptoms of capsular contracture can be subtle, such as vague discomfort or slight changes in breast shape. Advanced capsular contracture is more obvious because the firm tissue capsule around the implants will distort the shape of the implants and the breasts, and cause pain. (Bryan Correa, MD, The Woodlands Plastic Surgeon)

Capsular contracture in breast augmentation

One of the great controversies in breast augmentation surgery is the cause and treatment of capsular contracture. Capsular contracture is caused by the inflammation around the implant.

When this inflammation is appropriate and not overdone, the implant stays soft but still protected from the rest of the body.

For reasons that are not well understood, however, some people have an excessively robust response to the implant or something on it and the scar can become quite thick, tight, painful and visible.

When this happens, there are both non-surgical and surgical solutions that can be attempted.

An exam helps determine whether an excessively tight capsule is present but in general an implant that is higher, firmer, rounder and no longer directly situated above the breast is likely the product of a capsular contracture. (Christopher T. Maloney Jr., MD, Tucson Plastic Surgeon)

What are the signs of breast augmentation capsular contracture?

The foremost sign of breast augmentation capsular contracture is that the implants, in being “squeezed” by scar tissue, feel firmer. It can be mild, where one or both are a bit firmer, or it can be more severe where the implant(s) feel very hard.

Another sign is some elevation of the implant on the chest, where there is increasing unnatural fullness and implant projection in the upper part of the breast, the lower pole of the breast is less full or rounded, and sometimes the nipple is somewhat more down-pointing as a result of this superior implant “shift”. An examination by a plastic surgeon should be able to confirm the diagnosis. (Jeremy Pyle, MD, Raleigh-Durham Plastic Surgeon)

Capsular Contracture 10 Years After Breast Augmentation

If your breasts are beginning to feel more firm after ten years, this is a capsular contracture which is the hardening of the scar tissue around the implant.The implant itself does not get harder with time. A capsular contracture is a complication of breast augmentation surgery.

A capsular contracture happens when the scar tissue around the implant (the capsule) tightens and squeezes the implant.

If the breast augmentation capsular contracture begins to cause the breast to look abnormal or cause discomfort, this is fixed by performing a capsulectomy (removing the capsule) or capsulotomy (opening up the capsule). Sometimes the implant is removed and replaced with a new implant at the same time.

There is classification of breast augmentation capsular contracture.

• Baker Grade I: the breast is soft and looks normal
• Baker Grade II: the breast is a little firm but looks normal
• Baker Grade III: the breast is firm and looks abnormal
• Baker Grade IV: the breast is hard, painful, and looks abnormal.

Capsular contracture following breast implants

As you may know, breast augmentation capsular contracture can occur at any time when you have breast implants. You may develop it at one week post op, or you may have your implants for thirty years when suddenly they get hard.

The cause of capsular contracture is varied but I think bacteria plays a major role.

Signs of capsular contracture include changes in shape of the breast, change in position of the implant, and of course hardening of the breast.

Correction of this problem can involve implant change, change in the position of the implant, and removal of capsule. Usually this resolves the problem but in some cases implant removal is the only option. (Jeremy Pyle, MD, Raleigh-Durham Plastic Surgeon)

Signs of Capsular Contracture After Breast Augmentation?

When implants are inserted, your body forms a thin layer of scar, called capsule, around the implant. This is normally thin and pliable, but inflammation can cause the body to thicken this capsule, making the implant and capsule more noticeable. Plastic surgeons diagnose breast augmentation capsular contracture by the look and feel of the breast. In a normal breast augmentation the tissues feel soft and the capsule is not very detectable by feel.

If contracture develops the capsule thickens and shrinks around the implant making it feel thicker and tighter. In mild capsular contracture you can feel it, but the breast looks normal. In more significant capsular contracture, the outline of the implant becomes visible through the breast tissues. In severe cases, the condition may be painful and implants may look very round and high on the chest. Mild capsular contracture is often not treated.

Certain medications have been advocated by some to reduce capsular contracture, but science has not been able to substantiate claims and side effects can be severe. Significant capsular contracture is treated surgically to remove the scar tissue and soften the breast. Before undergoing breast augmentation, you should know that there is a significantly lower risk of capsular contracture when implants are placed under the muscle. If you are being treated for capsular contracture and have implants above the muscle, consider moving them under the muscle during your procedure to reduce risk of recurrence. (Robert M. Grenley, MD, Seattle Plastic Surgeon)