Early vs Later Capsular Contracture | Dr. Miguel Delgado, M.D

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The body’s protective response to a foreign body is the creation of a capsule around the implant. The formation of the capsule is normal, but if it should become thick or contracts, the implant can become distorted and painful. When a capsular contracture has occurred, the implant will feel hard, even though it is not the implant itself, similar to taking a fluffy pillow and stuffing it into a small pillowcase.

Causes of Capsular Contracture

The patient had 3 previous breast surgeries before seeing Dr. Delgado

Capsular Contracture #1 For Breast Revision Surgery

Capsular contracture is responsible for most breast revision surgeries. The rate of capsular contracture can vary significantly between surgeons.

Several factors may be responsible for the formation of scar tissue, such as:
• Surgical technique
• The location of the incision
• Placement of the implant
• Lack of massaging after surgery
• And more…

Inflammation is Primary Cause

Inflammation appears to be the primary cause of capsular contracture. If bacteria are present, the body’s reaction is inflammation which eventually may lead to scar formation. Sources of bacteria in the breast are:
• The milk ducts
• Blood in the pocket after surgery
• Irritants like surgical gloves that may have talc on them
• Damaged tissue from surgical trauma

Early contracture is believed to be connected to the surgery itself; blood, bacteria, and the body’s healing response. Some surgeons think that early contracture is harder to treat.

Dr. Delgado has a Very Low Capsular Contracture Rate

Dr. Miguel Delgado, M.D. takes many precautions to prevent contamination during surgery. The Keller Funnel is used to assist with the insertion of prefilled silicone implants. The benefits of the Keller Funnel are:
• “No touch” technique, gives increased protection against infection by never coming into contact with skin or the surgeon’s gloves
• Shorter incisions
• Less trauma to the tissues
Patients are given antibiotics through a drip at the beginning of surgery and a prescription to take at home for a few days. Dr. Delgado’s preferred method is the inframammary incision and placing the implants sub-muscular. He has noted that with all of these methods in place, his rate of capsular contracture has decreased dramatically.

Later Contracture Caused by the Immune System

Later contracture is believed to occur with the immune system breaking down, or if there is a microscopic bleed of silicone within the shell, it may result in inflammation. Some patients report that their breasts have become painful after a dental treatment or an infection elsewhere in their body.

There is still a lot unknown about capsular contracture. Plastic surgeons have different opinions, but all agree if you are noticing changes in your breasts, if they are swollen, tender, or painful, see your plastic surgeon right away.