Breast Augmentation: Cost, Reviews, Photos

Signs of capsular contracture

If you have noted a hardening of your breast implants over time, this is most likely the result of a capsular contracture.

A physical exam by your plastic surgeon would be the best way to confirm this.

The implants are most likely still soft, but they are encased within a thickening connective tissue rind around the implants which is compressing the implants and making them feel hardened.

Often, a capsular contracture will progressively distort the shape of the implants as well. There are several surgical treatments for the condition.

The surgical correction technique depends upon where your implants are located, the degree of the contracture, and your surgeon’s experience. (William T. Stoeckel, MD, Raleigh-Durham Plastic Surgeon)

The symptoms of capsular contracture after breast implants (augmentation).

EXAMINATION OF YOUR BREASTS FOR CAPSULAR CONTRACTURE. The four grades of implant contracture span the symptoms of capsular contracture problems experienced by some patients.

These grades start with a soft breast (with a thin capsule present), and progress to a firm breast with a normal appearance (Grade II). More contracture then causes the breast to be firmer still, with implant displacement or distortion (Grade III). Finally, the last grade of contracture is a painful, hard and abnormal appearing breast (Grade IV). Patients without visible distortion of their implants and without pain do not commonly seek further surgical care.

Grade III and Grade IV capsular contractures are, fortunately, uncommonly encountered in our practice. These two grades of implant hardness can benefit from surgical care. Your plastic surgeon should examine you, to answer your concerns, and probably would enjoy seeing you again, after 10 years, to evaluate your surgical outcome. (William T. Stoeckel, MD, Raleigh-Durham Plastic Surgeon)

How a Doctor Determines Symptoms of capsular contracture

Breasts that feel firmer than a normal breast should, indicate some degree of capsular contracture. After a breast implant is placed, the body lines the space the implant is in, with scar tissue.

In some patients, this space gets smaller, literally contracting, and eventually compressing the implant. The smallest possible shape is a sphere and can produce mis-shapen breasts. After breast augmentation, the breast softness is graded from I-IV.

• I being as soft as a natural breast.
• II being firmer than natural but still looking normal.
• III being firm and distorted in appearance.
• IV being very firm, very distorted in a appearane, and painful.

A board certified plastic surgeon will be able to diagnose if you have capsular contracture by examing and palpating the breasts.

Treatment options can then be discussed. If you do have capsular contracture and 10 year old implants, it will probably require surgery to correct and make the breasts soft and natural appearing again. (Douglas J. Raskin, MD, DMD, Colorado Springs Plastic Surgeon)

It sounds like capsular contracture and it can be diagnosed by a plastic surgeon. If they become painful or the assymetry becomes something that you cannot tolerate, you may need to do something about it. (Douglas J. Raskin, MD, DMD, Colorado Springs Plastic Surgeon)

Capsular contractures and breast implants

When you put in a breast implant, your body doesn’t like it. It can’t break it down and get rid of it, so it forms a capsule made out of scar tissue around the implant. This is fine. Everyone gets a thin capsule around their implants. You will probably never notice it. What you don’t want to see is a thickened capsule or tightening of the fibers in the capsule which can make the breast feel firm or distort the way it looks. This is called a capsular contracture. Capsule formation around around an implant can affect the breast along a spectrum from really soft breast to rock-hard breasts. The scar tissue itself is not dangerous to you. It is just scar tissue. As for it being a problem, it is really only a problem if it bothers you. I have seen some patients who actually like firmer breasts. If you get a capsular contracture, you have three options:

1. Do nothing.
2. The doctor can squeeze on the breast to try and break up the capsular contracture. This can be very uncomfortable for the patient (and the doctor) but, if it works, it will soften up the breast again. The capsule will have been ruptured but not removed so there is a good possibility that it will occur again in the future. There are other risks with this procedure as well such as bleeding, breaking an implant, etc. These should be discussed with your doctor.
3. Surgical removal of the capsular contracture. This obviously requires another surgery and it is a good idea to change something (different implants, different pocket, SOMETHING) to try and prevent the same thing from happening again. (James C. Pietraszek, MD, San Diego Plastic Surgeon)

Capsular contracture is graded by what is called the Baker scale.

A Baker 1 capsule is a soft/normal capsule reflected by a soft breast implant.

A Baker 2 capsule results in an implant that feels firm due to the capsular contracture.

A Baker 3 capsular contracture creates a firm implant that is also displaced by the capsule.

A Baker 4 capsular contracture creates a firm implant, that is displaced by the capsule, and is also uncomfortable or painful. I sincerely hope that you never experience anything other than a Baker 1 capsule! (Sugene Kim, MD, FACS, Houston Plastic Surgeon)

Signs of Capsular Contracture After Breast Augmentation

There are typically different stages of capsule contracture after Breast Augmentation. If the capsule is soft mobile and supportive then it is not considered pathologic or problematic.

If the breast starts to create and develop firmness, change in appearance, create discomfort, roundness, or change in size; then one might be developing different stages of capsular contracture.

If there is a significant change then contact your doctor to access the changes. (Richard Bloom, MBBS, FRACS, Melbourne Plastic Surgeon)

The diagnosis of capsular contracture is essentially based on clinical examination. If your implants have changed shaped and become firmer, then it is likely that you have a capsular contracture. It is possible that this could have been caused by a rupture of your implant or a silicone leak, but either way the implants will have to be exchanged, so further investigations eg MRI or mammogram are not really required.

My advice would be to go and see your original surgeon, assuming they are still operating, as they will still have your original records.  (Christopher J. Davidson, MD, FACS, Boston Plastic Surgeon)

Signs of Capsular Contracture

Capsular contracture can often be recognized by – change in shape of one or both breasts (rounder: implant seems too high) – difficulty moving the implant during routine breast massage – firmness – Occasionally pain (Christopher J. Davidson, MD, FACS, Boston Plastic Surgeon)

Capsular Contracture After Breast Augmentation

Capsular contracture is a result of scar tissue forming around the implant. This often causes pain and stiffness, along with hardening of the implant and breast.

In mild cases, you can feel the contracture but often don’t see it. In more severe cases, the actual outline of the implant become visible and it is likely that the implants will look very high on the chest. To accurately diagnose if you are suffering from capsular contracture, you should see your board-certified plastic surgeon so he can examine your chest.

The severity of your capsular contracture will determine what procedure is needed to correct the problem. After your plastic surgeon examines you, he will be able to recommend the best treatment for you. (Paul S. Gill, MD, Houston Plastic Surgeon)

Capsular contracture after breast augmentation.

The late development of firmness and pain in an augmented breast is invariably the result of capsular contracture. The fibrous tissue around the prostheses tightens and thus diminishes the pocket for the implant which causes the firmness and possible distortion. You see it more frequently with silicone prostheses , since over time molecular silicone can leach into the surrounding tissue stimulating the contracture process itself.

If severe enough it requires an open release ( capsulotomy) or excision (capsulectomy). The use of accolate and vitamin E has some efficacy in milder cases. (Paul S. Gill, MD, Houston Plastic Surgeon)

Unfortunately, it does sound like you have a “late” capsular contracture.

In the past, surgeons would forcefully squeeze the breasts to break up the capsule (closed capsulotomy), but this practice has been essentially banned.

There are some ultrasound or Erchonia Laser treatments that may help, but if not, then your only option is surgical removal of the scar tissue capsule and start with a new implant. (Christopher Khorsandi, MD, Las Vegas Plastic Surgeon)

Capsular Contracture After Breast Aug

Capsular contractures are symptomatic tightening of the scar capsule that normally forms around an implant.

They only feel hard when the capsule tightens down to a point where the space is actually smaller than the volume of the implant. It therefore increases the pressure inside the space and makes it feel like the implant is hard. your doctor can determine this by physical examination. (Melek Kayser, MD, Detroit Plastic Surgeon)

If you had silicone implants, you may need an MRI to determine the patency of the implant shell. The shell can deteriorate and silicone can leak causing a breast implants capsular contracture.

However even if the implant is intact, capsular contractures can occur at any time post op. Firmer or harder breasts are a sign of capsular contractures. Please have a consultation with a Board Certified Plastic Surgeon. (Ronald Schuster, MD, Baltimore Plastic Surgeon)

Signs of Capsular Contracture After Breast Augmentation

Breast implants capsular contracture occurs when the tissue surrounding the breast implant becomes dense and tightens around the implant and in turn compresses it.

If the tightening continues, the breast implant can become firmer and develop a ball-like shape. If the tightening still continues, the implant may even become painful.Capsular contracture occurs in four grades:

1. Grade 1 – This is the state where the breast looks natural and is soft.

2. Grade 2 – This is the state where the breast is firmer but looks normal.

3. Grade 3 – This is the state where the breast looks hard and is firmer.

4. Grade 4 – The breast looks abnormal, it is hard and painful.

Your surgeon may replace the implant and remove the scar capsule surrounding it, referred to as capsulectomy, based on your findings and symptoms.

Breast implants capsular contracture is one of the complications experienced most during breast augmentation.

It is important therefore to seek help from your surgeon for more guidance if you suspect you have this problem. (Ronald Schuster, MD, Baltimore Plastic Surgeon)

How long do breast implants last?

There are several problems that can arise following breast augmentation. One such problem is the development of scarring around the breast implant. This is known as capsular contracture; the breast capsule surrounding the implant progressively tightens causing palpability, visibility and pain.

These are Baker grades 2, 3 & 4, the clinical staging of breast implants capsular contracture. Breast implants are not permanent implants. I generally advise an MRI prior to re-augmentation to properly evaluate breast implants for rupture and to examine the breast capsule. (Christopher Khorsandi, MD, Las Vegas Plastic Surgeon)

Capsular contracture can be subtle or severe. An examination will help determine whether the breast implants capsular contracture is associated with a rupture of the implant. Raffy Karamanoukian Los Angeles (Raffy Karamanoukian, MD, FACS, Los Angeles Plastic Surgeon)

Any time a foreign object is implanted into the body (implant, pacemaker, portacath), the body responds by forming a “capsule” or scar tissue around it.

With breast implants, however, sometimes this capsule progresses and hardens, causing pain and distortion of the breast.

It is likely that you have developed at least a moderate capsular contracture given your description.

It is best that you go see a board certified plastic surgeon that can examine you and discuss the best option for you. (Robert Najera, MD, Frisco Plastic Surgeon)

Signs of breast capsular contracture After Breast Augmentation?

The common signs of breast capsular contracture after breast augmentation are increased tightness around the implant. As the capsule tightens it pushes the implant up on the chest. The patient can also note increased discomfort around the implant. I have noticed with saline implant that patient’s will complain that the implant is leaking but usually this is the capsule distorting the implant and making it appear smaller. All implants have a lifespan and at around 10 to 15 years replacement of the implants should be considered. The determination of capsular contracture is usually made on hearing the history from the patient and on physical exam. The surgical treatment can vary based on the clinical situation. I usually recommend removal of the capsule and replacement of the implant. (Johnny Franco, MD, Miami Plastic Surgeon)

Signs of capsular contraction after breast augmentation

The hardness of the breast is most likely a sign of capsular contraction. The breasts normally form thin scar capsules around breast implants as part of the body’s response to foreign objects. This is a normal response to anything put in your body. Usually, the scar is very thin, like Saran wrap, and the breasts remain soft.

If the scar capsule thickens over time, then the scar becomes firm. The thickened scars will contract(shrink) around the implants making them feel hard. Therefore, with rare exception, the hard feel of the breasts is d/t the scar capsule contracting. Your plastic surgeon can determine this usually by physical exam, although an imaging study may be needed(CT scan, MRI) (Robert Najera, MD, Frisco Plastic Surgeon)

Signs if capsular contracture after breast augmentation?

Physical examination will determine if you have breast capsular contracture. The look and feel of hardness surrounding your implant is seen and/or felt. It may also cause distortion of your breast. What has caused it will be in question. It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed.

If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall.

If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc). Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. (David Mathes, MD, Aurora Plastic Surgeon)

Breast capsular contracture signs and symptoms

One breast may not settle like the other side. You may also notice that one may be more firm than the other. The breast may appear to be displaced and/or distorted. You may also experience pain on the affected side. (David Mathes, MD, Chicago Plastic Surgeon)

Capsular contracture after breast augmentation

Whenever an implant is placed in the body, the body forms a capsule around it. Most of the time, this capsule remains soft and pliable, lending to a natural look and feel. Sometimes, the capsule begins to thicken and squeeze the implant, which manifests clinically as a firm or hard feeling implant, or a change in shape of the breast.

This is the capsule, not the implant that is actually hardening, and is called a capsular contracture. When this problem arises, your plastic surgeon will be able to assess the look and feel of the implants to help determine if you have a contracture, and how developed it is.

There are many operations to treat breast capsular contracture and in my opinion, it is important to removed the thickened capsule completely and place new implants into a new pocket. Sometimes this may necessitate going from subglandular to subpectoral (under the muscle).This is a common operation and If you are interested, a plastic surgeon in your area can discuss all the options available and what would be the best for you. (Niki Christopoulos, MD, FACS, Toledo Plastic Surgeon)