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Who can develop a capsular contracture?
The short answer is the scar tissue from your rhinoplasty is unlikely to be related to your risk for capsular contracture and anyone can get capsular contracture after breast augmentation. It is not completely clear what causes capsular contracture. Capsular contracture can occur as soon as 4 weeks after breast augmentation surgery. A capsule forms around any foreign body placed within the human body - this is a normal occurence and all breast implants have capsules around them shortly after surgery. The capsule is made of the following: Blood vessels Collagen Myofibroblast The capsular contractures can be identified as to a scaling from mild to very severe. The classis scale used by Board Certified Plastic Surgeons is the Baker classification. * Baker I capsule is a soft breast without significant scar tissue. * Baker II capsular contracture is a palpable scar tissue around the implant; however, not visible. * Baker III capsular contracture is associated with visible and palpable hardening, leading to a deformed shape to the breast. * Baker IV capsular contracture, most severe, is associated with hardening, palpable, visible and often a cold, hard breast that is very painful to even mild palpation. Usually people with Grade I or II implants don't even notice the capsule. Most surgeons agree there are things that predispose people to severe capsular contracture. These include: infection or contamination of the implants bleeding around the implant previous capsular contracture problems rupture of silicone implants (typically the older styles) In our Tri-Valley practice in Dublin we use techniques to significantly reduce the chance of our patients having these problems. We have also utilized techniques (like the placement of acellular dermal matrixes) to help patients who have had significant capsular contracture and have been referred for treatment by their original surgeon.
Clinical Context
Risk varies by patient and surgical factors. Implant pocket location matters: implants placed above the muscle (subglandular) tend to have higher contracture rates than those placed under the muscle. Prior radiation therapy, hematoma, infection, and bacterial contamination around the implant also raise risk. Contracture can appear months to years after an otherwise uneventful recovery, so ongoing follow-up matters. Reconstruction patients with a radiation history tend to have higher rates than cosmetic augmentation patients alone.
