Treatment of Capsular Contracture After Breast Implant surgery.

Treatment of Capsular Contracture After Breast Implant surgery.

What it is, why it happens, and how it is treated

What Is Capsular Contracture?

After a breast implant is placed, your body naturally forms a thin layer of scar tissue around it — called a capsule.
This is normal.

Capsular contracture occurs when that scar tissue tightens and becomes firm, squeezing the implant.
This can cause:

• Hardness
• Distortion of implant shape
• Breast sitting higher than normal
• Pain or discomfort
• Asymmetry

It can occur early (months) or many years after surgery.

The exact cause of capsular contracture is unknown.It can occur on one breast and not the other

How Is Capsular Contracture Treated?

Treatment depends on the severity, the type of implant, the pocket, and your goals.
Below are the standard treatments used by plastic surgeons — including those frequently used by Dr. Hilton Becker.

1. Medication (Very Limited Role)

Non-surgical treatments have not been consistently effective.
Sometimes early, mild cases may temporarily improve with:

• Singulair (montelukast)
• Vitamin E
• Antibiotics 
• Massage (only if surgeon recommends)

But these are not reliable for established contracture.

2. Surgical Treatment — the Proven Approach

A. Capsulotomy

Instead of removing the capsule, the surgeon releases it with precise internal incisions to soften the breast and give the implant space.
Used in certain cases where the capsule is thin or removal isn’t required.

B. Capsulectomy

Removal of the tight scar capsule around the implant.
Types include:

• Partial capsulectomy
• Total capsulectomy
• En-bloc capsulectomy (capsule and implant removed together)

The choice depends on:

• Severity
• Implant type
• Location
• Patient anatomy

Goal: Remove the contracture, relieve tightness, and start fresh.

C. Changing the Implant Pocket

Examples:

• Moving implant from above the muscle → below the muscle
• Moving implant from below the muscle → above, with internal support
• Creating a new, clean pocket (called neo-pocket)

By placing the implant into a new pocket, the risk of contracture returning is significantly reduced.

D. Using Acellular Dermal Matrix or Mesh (“Internal Bra”)

Dr. Becker is known for this technique.

Acellular dermal matrix (ADM) or surgical mesh can:

• Cover the implant  less exposure of the implant to the tissues
• Reinforce weak tissue
• Reduce recurrence of contracture
• Help shape the implant pocket correctly

This is often recommended for patients with repeated capsular contracture.

E. Changing the Implant Type or Size

Your surgeon may recommend:

• Using a different style (smooth vs textured)
• Downsizing to reduce tension
• Switching from silicone to saline
• Using an adjustable saline implant and keeping it overexpanded for a period of time and then reducing the volume.This serves to allow a larger capsule to form whichmayreduce recurrence 

F.  Post operative  physical therapy involving 

1 Soundwave Ionophoresis to facilitate antibiotic penetration  of surrounding tissue and any biofilm formation

2 Goal orientated massage and capsule stretching 

 G Removing Implants Altogether (“Explant”) 

Some women choose to remove implants permanently.
Dr. Becker often combines explant surgery with:

• Total capsulectomy
• Fat grafting to restore natural volume
• Mastopexy (breast lift) when needed

This creates soft, natural breasts without the risk of future contracture.

3. Fat Grafting as Part of Treatment

Fat transfer can be used to:

• Soften the breast
• Improve tissue quality
• Restore shape after implant removal
• Fill contour irregularities

It is often used to improve results and reduce implant visibility.

Why Does Capsular Contracture Happen?

Several factors may contribute:

• Bacterial biofilm
• Implant rupture
• Bleeding or trauma around the implant
• Sub-glandular implant placement
• Thin tissue or repeated surgeries
• Genetic tendency to form thicker scar tissue

Modern surgical techniques greatly reduce these risks.

Success Rates

Most patients experience:

• Softer breasts
• Improved shape
• Relief from tightness or pain
• Long-term stability when corrective steps are followed