Capsular contracture: how does it arise? What can you do about it?

Forming a capsule around any type of implant – medically or cosmetically – is a normal part of the healing process. The immune system automatically responds to the foreign object and tries to isolate the “intruder” by forming a barrier of connective tissue around it. In the case of breast implants, this is a good thing: The capsule helps to hold the breast implants in place, the strongly interwoven collagen fibers ensure that the implant can not slip once it is healed.

What is a capsular contracture?

Even with a capsular contracture, the body first begins to wrap the implant with connective tissue. However, too much: The capsule gets thicker and harder, it is called an “abnormal capsule formation”.

It is important to know that capsule fibrosis is not dangerous per se. It is not an infection, but in many cases just an aesthetic problem. With a strong capsular contracture, however, it can cause pain, because the fiber bundles pull on the surrounding tissue.

Kapselkontraktur und Kapselfibrose Dr Bartsch

How is a capsular contracture diagnosed?

Capsular contracture occurs, if at all, within the first month up to a maximum of 2 years after surgery. Mostly it is expressed by the fact that one breast is firmer than the other. As a result, the breasts look asymmetrical and also feel different.

The severity of fibrosis is differentiated by four stages. In the first two stages, the patient does not feel anything; pain only occurs from grade 3 onwards. Grade 4 shows a significant deformation of the affected breast.

The abnormal capsule formation can not be detected via ultrasound, X-ray or MRI. It is a purely clinical diagnosis, that is, the symptoms can initially only be perceived and described by the patient. You can judge the best, if you feel pain.

How does a capsular contracture develop?

The reasons for the development of capsular fibrosis are not 100% clear. It is now believed, however, that there is a subclinical infection – an infection that never breaks out, because the defense mechanisms outweigh and eliminate the pathogen before he can trigger a disease.

There is a higher risk if bleeding occurs during surgery. In addition, smooth implants are associated somewhat more frequently with the formation of capsular fibrosis than implants with a textured surface.

Are there any women who are more at risk than others?

Yes. Frequently, capsular contracture occurs after radiotherapy of breast tumors. Therefore, foreign bodies should generally be avoided after breast cancer treatment.

How is a capsular contracture treated?

Capsular contracture can be treated in two ways. On the one hand by capsule blasting: The doctor will try to blow the capsule by pressure from the outside, while the patient is in twilight sleep. The blistered capsule stays in the body, but capsule formation stops. This method is somewhat discredited, as it only succeeds in 50% of all cases. However, this also means that in half of the cases the patient can be spared an operation.

The operation would be the second treatment option: the implant and the capsule are removed and replaced with a new implant.

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