Capsular contracture can occur in patients who have breast implants. While there can be many reasons to have capsular contracture, I find that the more common reasons tend to be 1) history of hematoma or undetectable hematoma, 2) history of previous infection or subclinical infection, 3) long duration of implant placement, 4) patient specific factors (i.e. prone to keloid, hypertrophic scar, capsular contracture, etc.).
In patients who have a history of recurrent capsular contracture, despite previous capsulectomy, I have added to my management plan the following: At the time of capsule surgery, the implant is removed and the implant pocket is cultured. Post-operatively, the patient is placed on Keflex if able to tolerate, or clindamycin if there is a cephalosporin allergy. If the culture result is a bacterium not sensitive to Keflex or Clindamycin, then an antibiotic is chosen to fit the appropriate bacteria.
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