When breast implants (or any foreign object, such as pacemakers or artificial joints) are placed into the body, the body encapsulates it in a fibrous tissue lining. Many surgeons refer to this lining as the capsule, tissue capsule, or scar capsule, although it is not exactly the same as scar tissue. This is the body’s natural healing response after breast implant surgery and is to be expected.
Capsular contracture, the most common complication of breast augmentation surgery, can happen at any time, but seems to be more common in the first several months after surgery. In the initial operation, a pocket is created for the implant underneath the breast. During the healing process a capsule forms, which is comprised of fibrous tissue.
As the healing process continues during the first year, the scar tissue within the breast and around the implant will remodel and sometimes shrink. Under normal conditions the pocket remains open, allowing the implant to look and feel natural. However, some people can have an exaggerated healing response in the breast tissue during which the capsule will tighten, and squeeze the implant. This may cause the breast to feel hard, and to appear distorted. In severe cases, the implant feels very firm, may become painful and can take on a “ball-like” appearance. It’s important to remember that it’s not the implant that has hardened. The shrinking of the capsule compresses the implant, and causes it to feel hard, but once the implant is removed it’s just as soft as it was the day it was inserted.
Before & After Gallery
The best way to determine whether a surgeon is capable of giving you the results you desire is to view his past work and results.View the Before & After Gallery »
Capsular contracture revision surgery
While there are several procedures that can be used for capsular contracture treatment, Dr. Brenner only employs those with the highest success rate. His primary technique is called an open capsulectomy, in which he goes into the pocket and removes the scar capsule to release the capsule’s hold on the implant. Once the capsule is removed, your body will form a new capsule around the breast implant. Occasionally, Dr. Brenner will perform this procedure at the same time as implant pocket relocation to the submuscular position for women who have developed capsular contracture with their implants placed above the muscle.
Acellular dermal matrices in breast revision surgery
Capsular contracture historically has been a very difficult problem for breast surgeons to treat and manage, both for cosmetic and reconstructive patients. Lately, there has been a resurgence in popularity of implant-based breast reconstruction as well as breast augmentation. With these procedures, there is a distinct, inherent risk of developing capsular contracture (i.e. hardening of the layer around the breast implant). When severe, capsular contracture can result in a hard, painful and sometimes distorted breast appearance.
With an increase in capsular contracture, there has been an equally impressive resurgence in the use of acellular dermal matrices (ADMs), such as Alloderm or Strattice, in the treatment of capsular contracture. More commonly, plastic surgeons are using Alloderm in cosmetic procedures for correcting a number of potential deformities, such as rippling or malposition of breast implants.
In about 40-60% of patients who develop acute post-operative capsular contracture, use of asthma medications (i.e. Accolate) in an off-label fashion, has shown benefit in terms of improvement of severity of the contracture. Unfortunately, medications do not work for everyone and many patients require surgery.
Recent tests have shown that use of ADMs may help to decrease the risk of developing capsular contracture as well as the rate of recurrence, when used in breast revision surgery.
Asthma medication and capsular contracture?
In 1996 the FDA approved the use of zafirlukast (Accolate; AstraZeneca Pharmaceuticals, Wilmington, DE), a leukotriene receptor antagonist (LTRA), for thetreatment of asthma.
A few select patients who were prescribed Zafilukast for the management of their asthma symptoms noted that they also experienced improvement in the thickness and texture of their hypertrophic scars. Zafilukast was then given to a patient with a Baker Grade 3 capsular contracture following breast augmentation surgery. This particular patient experienced a softening and improvement of the severity of her capsular contracture.
Schedule Your Consultation Today
Call our office in Beverly Hills to get more information on breast revision surgery, and specifically the best capsular contracture treatment Los Angeles has to offer. Dr. Kevin Brenner is a board certified plastic surgeon and specializes in breast revision surgery, putting you in some of the safest, most caring hands available.Call us at 424-230-7779 today or click here to schedule online