The Surgeon Minute

The Latest in Preventing and Treating Capsular Contracture

The Latest in Preventing and Treating Capsular Contracture

Thanks to the internet, women today are better informed than at any other time in history. Which could explain why capsular contracture, something most of us had never heard of 20 years ago, is now the number one concern for those seeking breast implants. “Patients care about safety with the breast implants more than they even care about how the implant looks or feel.” says Dr. Bradley Calobrace of Louisville, KY.

And while capsular contracture is still very much a concern for surgeons and patients alike, the rates have decreased dramatically over the last decade. Why? Well, prevention is the key. Thanks to new techniques such as the use of nipple shields, antibiotic irrigation of the implant pocket and the no touch technique as well as placing the implant under the muscle and the rise in the use of textured implants, occurrence rates for capsular contracture have dropped from 10-15% down to just 2-3%.

by Katherine Stuart
and Brad Calobrace, MD

Capuslar Contracture Is Treatable

Although the percentage of patients today who get capsular contracture is small, it still exists. For those patients, it is important to remember that capsular contracture is treatable. Often without surgery. Dr. Calobrace’s first line of offense is medications such as Singulair and Accolate, anti-inflammatories used for asthma, extra Vitamin E, massage, and ultrasound therapy such as the Aspen Ultrasound which helps to break down the inflammation and stop the capsular contracture cycle. And if that doesn’t work then there is always the surgical option to remove the scar tissue, replace the implant, and change out the pocket if needed as well as repositioning the position from over the muscle to under and vice versa.

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It used to be thought that if you contracted capsular contracture once, you were at a higher rate to do so again, but Dr. Calobrace believes “it was because we were inadequately treating it. We didn’t know what we know today.”  In the past, surgeons just treated the capsule. They would put back the same implant. “Today, we treat the whole environment.”

For “breast cripples”, those patients who keep getting capsular contracture again and again and who were often left without hope, surgeons now have the ability to add a biologic/cellular dermal matrix material, basically artificial skin, into the pocket which can take the recurrence rate to almost 0. “In my practice today, doing all the preventative measures that we do, I haven’t seen a capsular contracture in almost two years in any of my patients. That was totally unheard of before. Prevention really does work.” says Dr. Calobrace.

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