What is Capsular Contracture? 

Capsular contracture is a condition that can occur following breast augmentation or reconstruction surgery involving implants. When an implant is placed in the body, it is natural for a layer of scar tissue, known as the capsule, to form around the implant as part of the healing process. This capsule is usually soft and thin, helping to support the implant and hold it in place. However, in some cases, the scar tissue becomes abnormally thick and begins to contract or tighten around the implant. This tightening can lead to various issues, including aesthetic changes, discomfort, and pain in more severe cases.

Capsular Contracture Grading Scale

Capsular contracture is graded on a scale known as the Baker classification system, which includes four stages:

  • Grade I: The breast appears soft and natural. The capsule is present but does not cause any noticeable symptoms, and the implant feels like a normal breast.
  • Grade II: The breast begins to feel slightly firm to the touch but still maintains a natural appearance. There may be minimal discomfort, but visual distortion is typically not present.
  • Grade III: The breast feels noticeably firm, with visible changes to its shape or position. The breast may begin to look unnaturally round, tight, or displaced, causing cosmetic concerns.
  • Grade IV: In the most severe cases, the breast is not only firm but also painful to touch. The breast’s appearance is significantly distorted, and the patient may experience chronic discomfort or pain, particularly when lying down or moving their arms.
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Signs of Capsular Contracture

Capsular contracture can develop months or even years after surgery. Common signs include:

  • Increased firmness or hardening of the breast
  • Changes in breast shape or position
  • Tightness or discomfort
  • Visible distortion, particularly in more advanced cases

Left untreated, capsular contracture can worsen, leading to increased discomfort and greater distortion of the breast. In severe cases (Grade III or IV), it can significantly affect appearance and sensation, potentially impacting quality of life. The breast may feel unnaturally firm, misshapen, or asymmetrical, and the tightness around the implant can result in chronic pain.

What Causes Capsular Contracture?

The exact cause of capsular contracture is not always clear, but it is believed to result from the body’s immune response to the foreign object (the implant). Factors such as inflammation, infection, or trauma may trigger an aggressive scar tissue response. Capsular contracture can develop at any time after breast implant surgery, from several months to years later.

  • Bacterial Contamination: If bacteria enter the body during surgery or through the bloodstream after surgery, it can increase the risk of an inflammatory response, potentially leading to capsular contracture.
  • Bleeding: Blood around the implant caused by uncontrolled bleeding after the initial surgery or spontaneous bleeding occurring afterwards is believed to be a risk factor for developing contracture.
  • Implant Rupture:  If an implant ruptures or leaks, it may irritate within the capsule, triggering scar tissue to thicken.
  • Body's Healing Response: Every individual heals differently. In some patients, their body’s natural response to the implant may involve forming thicker scar tissue.
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Breast Augmentation Alert Beware of THIS Common Issue

How Capsular Contracture Occurs and Ways to Avoid it.

Dr. Shim Ching explains that capsular contracture occurs when the body forms excess scar tissue around a breast implant, causing it to harden or become misshapen. 

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Endoscopic Capsulectomy

As Dr. Ching performs most of his breast augmentations with an endoscope through an armpit incision, he is one of the few surgeons in the world to offer Endoscopic Capulectomy in Honolulu with an armpit incision, avoiding a breast incision. Patients who initially had an armpit incision for the breast augmentation may choose this procedure as it avoids any scar on the breasts. As most of these patients wished to avoid a scar in the first place, this procedure is ideal for these patients. 

  • In this surgery, capsulectomy, replacement of implant and placement of Strattice or Ovitex is all performed with an endoscopic technique.
  • Often patients may elect to change their implants to the newer generation of silicone implants and change the size of both implants

Schedule Your Consultation Today

Dr. Shim Ching is a board-certified plastic surgeon with extensive experience treating capsular contracture. He is known for his meticulous surgical approach and commitment to personalized care, ensuring that every patient receives the most effective treatment for their needs. By combining state-of-the-art techniques with an artistic eye, Dr. Ching can restore your breast's natural appearance while minimizing discomfort.

If you need capsular contracture surgery in Hawaii, Dr. Shim Ching is here to help. With his expertise and compassionate care, you can achieve relief and regain confidence in your appearance. Contact our office today to schedule a consultation and learn more about your treatment options.

Meet Dr. Ching

Shim Ching MD
Best of Hawaii First Place award by KITV4
Top Doctor for 2023 in Honolulu Magazine
Castle Connolly Top Doctors 2023
Best of Honolulu 2023 Winner award
The Best Doctors in America 2019-2020

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