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Patients experiencing symptoms like breast stiffness, pain, and deformity after a breast augmentation may be in need of capsular contracture treatment in Washington, DC. Dr. Troy Pittman provides breast revision surgery to correct many conditions, including contracture.
The formation of a capsule around a breast implant is part of normal wound healing. The body’s natural response to a foreign object is to form a thin layer of scar tissue around the implant. However, in capsular contracture, that thin layer of scar tissue becomes thicker and causes a problem in women with breast implants. This problem occurs at four different grades:
Commonly, once capsular contracture reaches Grade 3 and 4, it is recommended that the patient undergo revision breast surgery to treat the condition.
There are a number of theories as to why some patients experience capsular contracture and others do not. It is likely that this development is multi-factorial.
Some believe that there is a genetic component. Patients that form increased scar tissue or have a history of autoimmune inflammatory conditions may be at an increased risk.
There is recent evidence to suggest that capsular contracture can be caused by a “bio-film.” A bio-film is a thin layer of bacteria that adheres to the implant, causing a low-level inflammatory condition that is not severe enough to cause the patient to feel ill. However, the chronic presence of the bacteria can cause an inflammatory response that leads to contracture.
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 thickening of the capsule.
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 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 important to note that 75% of incidents occur in the first 2-years after surgery.
In many cases, the formation of this condition is random and could be considered “bad luck.” However, there are many steps that can be taken to reduce the risk of developing the condition.
In Grade 1 and 2, no treatment is needed. If the implant pocket starts to feel firm and a smooth implant has been used, I recommend implant massage for two minutes a day. This can help with prevention of scar tissue formation. However, implant massage is not recommended for patients with textured implants.
With patients who have developed Grade 3 or 4 capsular contracture, surgery or other treatment procedures must be performed. Revision breast surgery is typically recommended. In most cases, this involves removal of the implant and complete removal of the breast capsule. Removing the implant without removing the capsule is counterproductive. In some circumstances, the patient may choose to her implants permanently removed. Most times, a small mastopexy or augmentation/mastopexy is necessary if implants are removed and/or replaced. Viewing before and after photos will help patients better understand the results of these corrective techniques.
After the chosen surgery has been performed, the patient will need to undergo a period of healing and recovery. This can involve a degree of swelling and bruising. During this time, it will be important to follow Dr. Pittman’s post-surgical care directions diligently.
It is important to note that once a patient has developed severe capsular contracture, her chances of it recurring are doubled. So at 10 years, her chance of having another contracture is close to 50%. There are certain things that can be done to help prevent it from happening again:
It is also important to note that implants that are too large for the patient out stress on the breast gland and can lead to a capsular contracture. Many times, I recommend downsizing to a smaller implant in revision surgery.
Before the price of a breast revision procedure can be determined, it will be necessary to understand the details of the specific case and the techniques that will be employed for correction. Once the exact techniques have been chosen, the treatment cost can be discussed in further detail during a consultation.
Ultimately, the best way to know your options is to book a consult with Dr. Pittman and discuss your goals. In your consult, Dr. Pittman will perform a physical exam and may perform an ultrasound exam. If there is a concern about breast implant rupture, Dr. Pittman may send you for a breast MRI and/or mammogram. The cornerstone of Dr. Pittman’s practice is treating each patient as an individual and devising a concierge surgical plan for each patient.
Schedule your consultation for capsular contracture treatment in Washington, DC – contact us today to arrange your appointment.