This corresponds with what I’ve been doing for the last several years. However now there is a published study that shows that Singulair works. This doesn’t make it work any better but it does further legitimize the off-label use.

As mentioned before, many different things can cause contracture after breast implants. Factors like bacterial contamination and hematoma. These can prolong the inflammatory response. A colleague and friend of mine, Dr.Schlesinger, discovered that a drug called Accolate, which is an anti-inflammatory asthma drug, worked in improving capsular contracture and published this. However it was discovered later on that Accolate had a very small incidents of extremely severe complications including hepatitis liver failure and death. This led to the abandonment of the use of Accolate despite the fact that it worked very well. Cingular is a similar type of drug. It is what is called a leukotriene inhibitor. These are factors that are thought to be responsible for capsular contracture.

This particular study on women with breast implants confirms what I have personally noted over the last several years. Cingular can help reverse capsular contracture when it is caught early and just starting. It can also help prevent recurrence. However, if someone comes in with established capsular contracture or extremely firm contracture it has little effect. The repair of very firm contracture is still a surgical procedure

Capsular contracture still continues to be an annoying and expensive problem in plastic surgery. By using techniques like the no touch Keller Funnel while placing breast implants during breast augmentation, see my previous blog about the Keller Funnel, IV antibiotics and antibiotic irrigation weekendreduce the incidence of contracture. However it is good to know that Singulair has been shown to be effective. In my own practice I combine it with cold laser to make it even more effective and see about 4 out of 5 people respond to the combination.

Now there is a very clever funnel invented by Dr. Keller called the Keller Funnel which accomplishes several purposes with something that looks like it belongs on the Food Network’s TV show Ace of Cakes!

First of all, it allows introduction of the implant with a true no touch technique the implant can be dropped into the funnel and then gently squeezed through like decorating the top of the cake. The surgeon doesn’t touch it and it doesn’t touch the patient’s skin or breast tissue while it is being introduced in the pocket. This eliminates the main source of potential capsular contracture which is residual bacteria on the skin or in the breast tissue of the patient

Secondly, this way of introduction puts less stress on the implant so that is less likely to break during introduction or later due to the stress placed while putting it in

And lastly, this method allows for smaller incisions and faster introduction minimizing scar tissue and lessening the time that the patient is under anesthesia

I am very pleased to now be using the new Keller Funnel that allows us to improve the quality of breast augmentation. At Advanced Concepts in Plastic Surgery we continue to select the best of new technology. The Keller Funnel is an example of this by making breast augmentation better, safer, and minimizing future complications.

Over the years at Advanced Concepts in Plastic Surgery of Sacramento various measures to decrease this exposure have been adopted. These includes our state-of-the-art surgery facility strict attention to sterile technique, better skin preparation 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 capsular 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.