Capsular contracture is the most common complication of breast implants. It consists of the creation by the body of a fibrotic tissue that we call capsule (periprosthetic capsule) that separates the implant from the rest of the body. The formation of a periprosthetic capsule is a normal reaction that the body makes when it encounters a foreign body that it cannot phagocytize and digest. To understand it, it would be the way in which it defends itself against inorganic foreign bodies that the immune system is incapable of digesting. The problem appears when that capsule thickens and contracts in an attempt to further protect itself from the foreign body. This is what we call capsular contracture and the result is an implant that is hard to the touch, deformed, sometimes painful…
How do I know if I am having capsular contracture?
Early diagnosis is really difficult even for highly experienced plastic surgeons.
- Breast pain : When the capsule contracts around the implant, the implant may wrinkle to fit the new, smaller envelope, and those wrinkles or peaks can cause pain. However, pain is not an early sign of capsular contracture. After a breast augmentation there is always pain and even a sensation of cramping or stinging. All of these symptoms are totally normal and do not indicate capsular contracture.
- Hard touch : Hard touch of implants is usually an obvious but late sign of capsular contracture. When the capsule contracts around the implant, the implant folds, the silicone gel is concentrated in a smaller space and that makes it harder to the touch. Traditionally, the capsule will contract until the resistance of the silicone gel is greater than the force that the scar tissue can exert, that is, it can no longer concentrate in that space.
- Alterations in the position of the implant, rise of the implant: The rise of the implant in the thorax is a clear and early sign of the beginning of capsular contracture. Retraction of the capsule, before producing hardness to the touch or pain, deforms the position of the implant, generally elevating it in the thorax. We can also observe this sign when after a mastopexy with a prosthesis, the breast, far from falling, rises, and the nipple begins to point down instead of pointing up.