Capsular Contracture Treatment

Several theories exist regarding why some patients develop capsular contracture while others do not. This development is likely multifactorial.

Genetics

Some believe that there is a genetic component to the condition. Patients who form increased scar tissue or have a history of autoimmune inflammatory conditions may be at an increased risk.

Bio-Films

Recent evidence suggests that capsular contracture can be caused by a “biofilm.”  A biofilm is a thin layer of bacteria that adheres to the implant, causing a low-level inflammatory condition that is not severe enough to make the patient feel ill. However, the chronic presence of the bacteria can cause an inflammatory response that leads to contracture.

Post-Operative Issues

Certain other circumstances, such as a post-operative hematoma or seroma, can lead to capsular contracture.  It is important to remember that inflammation begets inflammation, so any circumstance that induces an inflammatory response can lead to the thickening of the capsule.

Breast Implant Safety

It is important to note that this development has NOTHING to do with breast implants being unsafe or dangerous. In all of the 10-year core studies that the FDA required implant manufacturers to complete, the incidence of this condition in 4th and 5th generation implants is about 2% per year. Therefore, at 10 years, there is about a 20% chance that a patient with implants will develop Grade 2-4 capsular contracture. It is essential to note that 75% of incidents occur within the first two years after surgery.  Furthermore, we are happy to report that the incidence of capsular contracture with the Motiva 6th-generation implants (for which Dr. Pittman was the first surgeon in the DC Metro Area to use) is under 1%.

In many cases, the formation of this condition is random and could be considered “bad luck.”  However, many steps can be taken to reduce the risk of developing the condition.

Careful patient selection

Patients who have a history of severe scar formation or adhesion formation after abdominal surgery should be counseled on the increased risk of developing capsular contracture.  Additionally, patients at high risk for developing hematomas, such as those with bleeding disorders or those who are actively smoking, should be screened appropriately.

Meticulous sterile technique in the OR

It is essential to minimize the handling of the implant during the operation.  Precautions are taken to ensure that the pocket is irrigated with an antibiotic solution to help decontaminate the pocket and minimize residual bleeding in the implant site.  I use a device called the Keller Funnel, which allows us to insert the implant through a tiny 3-cm incision without directly touching the implant.

Motiva Implants

Motiva Implants have been used worldwide for nearly 15 years and were recently approved by the FDA for use in the United States.  Dr. Pittman was the first surgeon to use Motiva implants in the mid-Atlantic region.  The surface of the Motiva implant is constructed in such a way that makes the implant biocompatible, and the rates of capsular contracture are unprecedentedly low.

Capsular contracture treatment is generally smooth, and most patients report minimal discomfort. Since you’ll be under anesthesia, you’ll not experience any pain during the surgery. Afterward, some swelling and tenderness are typical as your body heals, but these sensations usually subside within a few days.

You’ll start with a consultation with Dr. Pittman at Somenek + Pittman, MD, where he will assess your situation. You’ll then have the day of your procedure, followed by some scheduled check-ins to ensure everything is healing as it should. Depending on your progress, additional follow-ups may occur; however, the process is designed to be as convenient and efficient as possible.

The results of capsular contracture treatment will gradually become more noticeable as your body heals. While you may see some improvement within the first few days to weeks, the final outcome typically takes a few months to fully take shape as swelling diminishes and the implants settle into their natural position.

Many patients choose to address additional concerns, such as revisions to breast implants, fat grafting, or even facial rejuvenation treatments, all in one go. Dr. Pittman at Somenek + Pittman MD in Washington, D.C., will assess your needs and create a customized plan that maximizes your results while ensuring everything is done safely and effectively.

As with any procedure, capsular contracture treatment carries a few risks. While rare, patients might experience issues such as infection, abnormal healing, or asymmetry. Temporary swelling or bruising can also occur, but typically subsides during recovery. In the rarest of cases, the condition could return.

Dr. Pittman at Somenek + Pittman, M D, takes a cautious, personalized approach to minimize these risks. He’ll ensure you understand what to expect and guide you through a safe and effective treatment plan tailored to your needs.