Tuesday, December 1, 2009

Capsular Contracture & Capsular Contracture Surgery

Capsular contracture is a common sequelae of breast augmentation surgery. When a breast implant or other medical device is placed in the body a lining may form around the device. The lining that is created is the body's natural response. In some individuals or in some scenarios the lining that forms can contract or thicken aggressively which is an unnatural or undesirable response of the body to the breast implnat. When the lining contracts around something that is soft, such as a breast implant, the surface area: volume ratio of the lining: implant changes.

When the surface area lining decreases around the fixed implant volume, the construct becomes hard. This hardening of the implant can cause significant pain to the patient and may temporarily disfigure the breast until the capsule is released or removed. There is a four grade classification scale, the Baker Grading Scale to describe capsular contracture:

Grade I - The breast is soft, and appears natural.
Grade II- The breast is firm, but still appears natural.
Grade III - The breast is firm, and is beginning to appear distorted in shape. Grade IV- The breast is hard, distorted in shape, and is painful.

Typically patients present to our office when a Grade III or Grade IV capsule has developed. Often patients choose to undergo surgery for their capsular contracture for these grades secondary to pain or because the distortion has changed the appearance or begins to interfere with mammography.

The above patient presented with bilateral painful Baker IV capsular contracture that was surgically corrected with bilateral "en bloc" capsulectomy, change of implant plane, and replacement of the breast implant.

Capsular contracture surgery is commonly performed in both the Beverly Hills and Newport Beach, CA locations.

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