Wednesday, January 12, 2011

What is Capsular Contracture (A Common Complication of Breast Augmentation)?

Capsular Contracture, a Common Complication of Breast Augmentation

Capsular contracture has been one of the most commonly  reported complications  of breast augmentation.  Capsular contracture is the complication of breast implants when the breast tissue surrounding the implant hardens which may cause a deformity of the breast or even cause some breast pain.  This is one of most significant cause of patient dissatisfaction following this type of cosmetic surgery.
   
Severe capsular contracture of the right breast after subglandular breast implant/augmentation.
Photograph courtesy of Walter Peters, Ph.D., M.D., F.R.C.S.C., University of Toronto (Wikimedia Commons)
The rate of capsular contracture has been reported to range from 0 to 59 percent.  The variability of the capsular contracture rate could depend on multiple factors:  textured versus smooth breast implants, placement of breast implants underneath or above the pectoral/chest wall muscles, the use of saline or silicone breast implants, and the type of irrigation used during surgery.  
Textured breast implants have been found to have a lower rate of capsular contracture than smooth implants, whether silicone or saline breast implants were used.  Several studies, however, have conflicting results and thus inconclusive.  Moreover, textured breast implants may cause visible rippling which may cause some patient dissatisfaction.   Some patients, thus, may prefer a smooth shell when using saline breast implants due to the less palpability of the implant.
Placing the breast implant underneath the muscle may be associated with a lower rate of capsular contracture.  However, the findings in several clinical studies were not universally consistent.
Previously, silicone breast implants were found to have a higher risk of capsular contracture when compared to saline breast implants.  With the new generation of silicone breast implants, however, the capsular contracture rate was found to be significantly different (lower rate) from the older ones.  A recent study showed that there was no significant difference  between silicone breast implants and saline breast implants with regards to clinically significant capsular contracture.   A recent systematic review of the literature, however, has not elucidated a consensus whether there is a difference in the rate of capsular contracture between saline and silicone breast implants.
I recommend to discuss with your plastic surgeon  their preference regarding the type of implant and location that he/she uses for breast augmentation.  One of your Houston cosmetic surgeons will guide you during the process of your surgical decision to achieve the best possible outcome.
Emmanuel De La Cruz M.D.
http://www.delacruzplasticsurgery.com/ 

P.S.
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Reference:
Handel N, Jensen JA, Black Q, Waisman JR, Silverstein MJ. The fate of breast implants: A critical analysis of complications and outcomes. Plastic & Reconstructive Surgery.. 1995;96:1521–1533.

Schaub T., Ahmad J., & Rohrich, R.  Capsular contracture with breast implants in the cosmetic patient: Saline versus Silicone-A systemic Review of the Literature. Plastic & Reconstructive Surgery. 2010 December;(126)6  2140-2149

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