Capsular contraction revisional surgery and its reoccurrence

 

A big portion of the patients considering revisional breast surgery are doing so because of capsular contraction, which is a typical side effect of breast augmentation with implants. According to studies, capsular contraction occurrence rate ranges between 0.5% to 30%.

 

However, in case of primary (first-time) breast surgery the occurrence rate of capsular contraction is about 0.2~0.3%.

There are a lot of causes and factors contributing to the occurrence of capsular contraction, so in order to avoid it, it’s important to prevent the causes.

 

 

Left – normal formation of scar tissue / Right – abnormally thick formation of scar tissue

 

As implants are inserted, scar tissue forms around it.

In case of the left picture, we can see the scar tissue is thin and there is a wide space between the implant.

On the right picture we can see typical formation of a thick scar tissue, which is contracting around the implant, making it hard to the touch.

 

Will capsular contraction reappear after revisional surgery?

 

According to statistics, there is between 30~50% chance of reoccurrence of capsular contraction after having a revisional surgery to remove it, which is a much higher probability than before the first breast surgery.

We still don’t know exactly what causes capsular contraction, but most common causes are inflammation and hemorrhage, but it can be also caused by the implant or various other factors such as genetics.

 

 

What method can be used?

 

When proceeding with surgery it’s important to identify the cause of capsular contraction to avoid its occurrence. Its probability can be reduced when surgery is performed with utmost care, by using the capsular contraction medication and avoiding the risk of bacterial infection.

 

​

However, if capsular contraction occurred after primary surgery due to unknown cause, and if revisional surgery is done using the same method, chances of it reoccurring are very high.

 

​In case of capsular contraction occurring with no clear reason, we always recommend using artificial dermis for revisional surgery at our hospital.

 

When artificial dermis is used, it can reduce the formation of scar tissue and with this reduce the probability of capsular contraction.

By inserting an implant which was partially covered with artificial dermis, the probability of capsular contraction appearing again can be reduced to about 1%.

​

Capsular contraction reoccurring is probably the biggest concern for patients considering revisional surgery. While it is true that the chances are high, if we analyze the causes and proceed to find a solution based on them, we can minimize those concerns.