To that end, plastic surgeons now employ a number of different preventative strategies, as outlined below:. In the past, the treatment options available for breast augmentation patients with capsular contracture left much to be desired. Revision surgery was often required—a lengthy, costly and uncomfortable solution.
During this process, the patient's implants were removed, she was treated with antibiotics and eventually once the infection had subsided , she could choose to have breast implants inserted again. However, because this surgical approach makes the body vulnerable to a second bacterial invasion, many of these patients experienced repeated incidences of capsular contracture. Aspen multi-energy therapy is different. It's completely noninvasive, so it doesn't cause the patient pain or inconvenience, nor does it increase her risk of developing capsular contracture again in the future.
During Aspen therapy, a special device the Aspen harmonizer is applied to the patient's breast tissue, without any incisions being made.
The Aspen harmonizer delivers precisely controlled ultrasound waves to the patient's tissue, encouraging the growth of healthy collagen.
This increases elasticity within the breast capsule around the implant, making the breasts feel soft and pliable again. Furthermore, the ultrasound waves used during Aspen therapy have been shown to increase the effectiveness of antibiotics in combating biofilm.
Aspen therapy is usually administered over two to three weeks in combination with antibiotic therapy to target the root cause of capsular contracture. The Aspen method has been shown to be effective for grade two and grade three cases of capsular contracture. Grade four cases may require more aggressive surgical intervention.
If you're a good candidate for Aspen therapy, this pain-free procedure can treat and reverse capsular contracture. Contact a board-certified plastic surgeon to learn more about this procedure. The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.
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Share your journey with other people just like you on the Patient Community or post your question to Ask a Surgeon to get an authoritative and trustworthy answer from our ASPS member surgeons. Share your journey with other people just like you on the Patient Community. My Account. News Blog What is capsular contracture and how can it be treated?
What is capsular contracture? The severity of capsular contracture is rated using a grading system: Grade 1: Grade one capsular contracture is asymptomatic producing or showing no symptoms. The formation of scar tissue around the implant does not interfere with the size, shape or texture of the breasts. The breasts look natural and remain soft to the touch.
Grade 2: Grade two capsular contracture usually presents itself with only minor cosmetic symptoms. The breasts will usually appear normal in shape but feel somewhat firm to the touch. Grade 3: Grade three capsular contracture presents itself with obvious cosmetic symptoms. The breasts will be firm to the touch and appear abnormal, e. However, this incidence is quite rare—I have only seen it in a small handful of my patients.
Most patients do very well without any major problems! Capsular contracture describes circumferential constriction of scar tissue around a breast implant that causes the breast to feel firm, look distorted or have a sharp, round edge around it—or in the worst case, to be painful. It is graded from Grade I the breast is soft and normal , Grade II the breast looks normal but feels firm , Grade III the breast is firm and visible distortion or deformity can be seen and, finally, Grade IV the scar tissue around the implant is painful.
The leading theory about why and how capsular contracture occurs is due to an irritant around the implant once it is in the body, such as bacteria or blood. At my practice, we take many steps to prevent introduction of bacteria around the implant and removal of blood from the implant environment to avoid capsular contracture from occurring, starting on day one. These prophylactic measures include a dose of intravenous antibiotics at the start of surgery before an incision is made; the use of drains to remove wound fluid that is produced by the body around the implant during healing; the use of postoperative oral antibiotics until the drains are removed three to six days on average ; and instructions to avoid showering the surgical area until 24 hours after the drains are removed.
In addition, we recommend that procedures that naturally stimulate bacteria being stirred up and potentially entering the bloodstream including teeth cleaning, dental procedures, sinus surgery, rhinoplasty , septum surgery, colonoscopy or endoscopy be avoided for three months after surgery.
What happens at three months? Nothing magic! I tell my patients that there is no blood test or physical exam finding that gives them a higher risk. Even more perplexing is that most contractures only occur on one breast even though both breasts have the same implants. Capsular contracture is difficult to predict or prevent.
You may reduce your risk of developing it by selecting an experienced and board-certified plastic surgeon for your breast augmentation procedure. Lower occurrence rates are seen when the implant is placed under the chest muscle instead of just under the breast tissue, using an incision at the breast crease inframammary approach instead of around the areola, as well as avoiding smoking or taking medicines that thin the blood.
One scientific literature review indicated that the capsular contracture rate affects Since , the risk in my patient population ranges from two to five percent.
The risk does vary depending on the implant you choose. Also, your chance of getting capsular contracture will be higher if you have already had capsular contracture in the past.
Your likelihood will be lower if you follow the recommendations for prevention and if you are a naturally good healer. Capsular contracture can occur at any point after breast augmentation and without any warning. Most cases are likely to take place within the first two years after breast augmentation. Patients with mild cases of capsular contracture Grade I or possibly Grade II may not need corrective surgery.
If there is no visible distortion and you are not bothered by your capsular contracture, you may choose to ignore it. In regard to nonsurgical treatment for capsular contracture, it is thought that some substances such as anti-inflammatory medications or vitamin E supplements may help soften the scar capsule.
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