Capsular contracture, as a plastic surgeon in Sacramento, I get this question a lot. Capsular contracture is the most common undesired plastic surgery outcome with breast augmentation. The rates are reported to be as high as 30%. In my practice at Advanced Concepts in Plastic Surgery of Sacramento this is roughly 5%. Anatomically this is the process of shrinkage of the scar tissue that normally forms around every breast implant. This is usually thin, about the thickness of a sheet of paper. Normally this leaves an enlarged pocket in which the implant can move around, or with a textured implant a smaller pocket that fits the shape of the implant. However when this occurs the scar tissue shrinks, the implants feels hard, looks distorted, and may even be uncomfortable or painful. Nobody really knows the answer why some people get it and others don’t. And when they do why is it almost always only on one side and not the other? No one really knows the answers but the solution is coming close. One of the working theories deals with possible mild low-grade infection from the patients skin or breasts. This is because bacteria have been cultured or found in the scar tissue of patients with contracture. Despite using sterile gowns and gloves, and sterilizing skin with content microbial soap, all of the bacteria can not be removed. About 99% are removed but sometimes this is not enough.
Over the years various measures to decrease this exposure have been adopted. These included strict attention to sterile technique, better skin preps as well as rinsing the pocket with Betadine, antibacterial solution, IV antibiotics, no touch techniques, (trying to avoid touching skin) and changing gloves for implant insertion. All of these have been beneficial to a certain extent but the percentage of contracture is still never zero. Research goes on.
So what can be done if someone gets contracture? Recent research shows that a class of drugs called Leukotriene Inhibitors which have usually been used for asthma have been effective in reversing these changes. These drugs include Singulair and Accolate. Another method to help reverse this problem is Low Level Laser Light. This activates cellular energy and seems to help soften the scar tissue especially when it is combined with constant pressure during treatment.
As a last resort a second surgery removing the scar tissue and removing the implant can be done with good results. If done early, this is a simple operation and involves less downtime, discomfort, or recovery than the original procedure.