Complications of breast augmentation – capsular contracture

Fortunately, serious breast augmentation surgery complications are very rare. There are some less serious complications that may occur and at some point, may require corrective plastic surgery. Capsular contracture is one of these plastic surgery breast implant complications that may require a second plastic surgery.

The breast implant during breast augmentation surgery is placed above or below the muscle and within approximately two weeks, a thin layer of scar tissue forms along the pocket that was created. This layer of scar tissue is typically the thickness of a thin grape skin. Some plastic surgeons only create a small pocket when placing the breast implant which is just large enough for the breast implant to be positioned. In this case the implant scar tissue pocket or ‘capsule’ is close to the breast implant. Other plastic surgeons will create a large and generous pocket in which to position the implant. If the implant is moved during this early healing stage, the scar tissue capsule forms away from the breast implant so a larger pocket forms. Generally speaking, the breast implant avoids becoming contracted by the scar tissue due to this pocket manipulation.

Over a period of time, in some breast augmentation patients, the scar tissue capsule will become thicker and tighten around the breast implant. This scar tissue layer can become the thickness of an orange peel. This tightening is called ‘contracture’ and when this occurs it is called a capsular contracture. A breast capsular contracture may be mild to very severe. It can lead to mild to marked distortion of the breast shape and even cause pain in its later stages. Capsular contracture can occur using either silicone or saline filled breast implants although it was recently discovered that the occurrence is slightly higher with silicone.

In mild cases, the scar tissue capsule may be partly removed and the remainder cut to release any tightness. When the scar is released, a new wider layer is formed and the capsule is larger.

In severe cases, a secondary plastic surgery is required to completely remove the capsule scar tissue. It is more common to see this type of capsular contracture in older silicone gel implants placed above the muscle.

It is most common to see capsular contracture in breast implants placed above the muscle. Capsular contracture may be caused by blood that was left or collected around the implant after the breast augmentation surgery. Capsular contracture may also be caused by a low grade infection that has been contained in the scar tissue pocket. Sometimes this occurs because the woman’s body has continued to place scar tissue around the implant. Capsular contracture is not a ‘rejection’ of the breast implant. It is a complication or consequence that may occur after breast augmentation surgery.