When a breast implant – or any foreign object – is introduced into the body, the natural response for the body is to encapsulate the “intruder” inside a thin layer of scar tissue (which we call a “capsule”) to “wall it off” and prevent it from causing harm to other tissues. The majority of the time, this capsule remains extremely thin and unnoticed, though in some instances it can thicken and tighten around the breast implant, resulting in what’s referred to as “capsular contracture”.
Silicone elastomer shell is the “chemical” that makes the “shell” or “skin” of a breast implant either in saline or silicone gel breast implants. We know from chemistry that silicone is inert and non-reactive with the body, and it is also well accepted. In my practice, capsular contracture is very remote in patients; however, as a breast revision specialist, I see and treat many contractures that may have developed for a variety of reasons after procedures performed elsewhere.
Capsular contracture can happen in one or both breasts, and it often causes the implant to feel firm – sometimes quite hard. We can see this in the early months after augmentation, or it may even occur years later. It is important to note that all non-living devices placed in the body eventually wear out and need to be replaced. When aging silicone gel implants (usually 20 years or more in age) rupture, the implants are still “walled off” by the capsule, but the ruptured silicone will generally cause capsular contracture. In severe cases, the condition can be painful and may even distort the position and/or shape of the implant(s), resulting in an abnormal appearance, and even more importantly, an abnormal feel (or hardness) for the breasts. Although more common in individuals who have “older silicone implants”, capsular contracture can occur around any type of implant.
At my practice, I employ a number of advanced techniques that can help minimize the risk of capsular contracture for patients interested in breast implants. Additionally, for women who have capsular contracture resulting from a previous augmentation, I also perform innovative revision breast augmentation techniques such as neo pocket and Strattice® dermal grafting. The neo pocket method “peels” away the old capsule, allowing a new and fresh tissue interface for the breast implant. Strattice® is an acellular dermal matrix that covers the lower portion of the breast implant and helps prevent recurrent contracture from occurring with the new capsular formation. These innovative approaches have proven to produce excellent, natural-looking results with an improved implant shape and feel for qualified patients.
– Dr. James F. Boynton, Board Certified Plastic Surgeon
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For more information about capsular contracture, or if you would like to schedule a breast revision consultation with Dr. Boynton, please contact us today.