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Capsular Contracture

capsular contractureCapsular contracture occurs when the scar tissue, that naturally forms a capsule around the implant, tightens excessively and squeezes the implant. The severity of the capsular contracture is measured over four grades known as Baker Grades. The scale is reproduced below:

  • Grade 1: Breast is normal, soft and natural in appearance
  • Grade 2: The breast is somewhat firm but maintains a normal appearance
  • Grade 3: The breast is firm and has an abnormal appearance.
  • Grade 4: The breast is hard, painful and has an abnormal appearance

The above photo shows a lady with capsular contracture in her right breast.

The risk factors contributing to capsular contracture are unclear. However, it is thought that experiencing an infection, haematoma and smoking prior to surgery may be risk factors. Also, breast implants placed on top of the muscle tend to have an increased incidence of capsular contracture compared to those placed underneath the muscle.

What can be done for capsular contracture?

There are a number of procedures, including:

  • Closed Capsulotomy, where the surgeon forcibly squeezes the implant in the hope of rupturing the scar tissue. This is not recommended because it puts you at risk of implant rupture.
  • Open Casulotomy, where the surgeon surgically cuts the scar tissue to release the pressure on the implant.
  • Open Capsulectomy, where the surgeon removes the entire scar capsule. This operation has the greatest success rate, although a new capsule will form around the implant.