Capsular Conctracture Treatment Q&A With Dr. Cassileth

Authored By Lisa Cassileth MD, FACS



Capsular contracture is a side effect that some women experience after breast augmentation. After the breast implant surgery, fibrous tissue forms around it, creating a capsule. This is the body’s natural response to a “foreign object”. The tissue capsule is usually soft or slightly firm, not noticeable, and helps to keep the implant in place. In some cases, the capsule becomes unusually hard or dense and cause discomfort, pain, or hardening of the breast known as capsular contracture.

Capsular contracture treatment is one of Dr. Lisa Cassileth’s passions. She is skilled at correcting and restoring the breast to a natural look and feel . Her premier plastic surgery practice in Beverly Hills has treated hundreds of complicated capsular contracture cases and she has developed and perfected her “no-touch” breast augmentation technique. Her continuous work and expertise in the treatment of capsular contracture has deemed her national recognition.

We’ve compiled a list of frequently asked questions and answers that patients often ask about capsular contracture treatment below:

Q. What are the different grades of capsular contracture?

Grade 1: Grade one capsular contracture shows no symptoms. The formation of scar tissue around the implant does not interfere with the size, shape or texture of the breasts. The breasts look natural and remain soft to the touch.

Grade 2: Grade two capsular contracture usually presents itself with only minor cosmetic symptoms. The breasts will usually appear normal in shape but feel somewhat firm to the touch.

Grade 3: Grade three capsular contracture presents itself with obvious cosmetic symptoms. The breasts will be firm to the touch and appear abnormal, they may be overly round, hard-looking and the nipples may be misshapen. This grade of capsular contraction often doesn’t cause pain.

Grade 4: Like grade three capsular contracture, grade four capsular contracture causes the breasts to become hard, misshapen and misplaced on the chest. Patients with grade four capsular contracture also experience breast soreness; their breasts will often be tender and painful to the touch.

Q. What are the Treatments for Capsular Contracture?


Dr. Cassileth removes the existing implant and the surrounding tissue capsule and inserts a new implant wrapped in dermal matrix material (a skin substance made mostly of collagen). The dermal matrix provides an extra protective layer, and the body will form a new capsule of scar tissue around it.

Open capsulotomy:

Dr. Cassileth makes small incisions in the capsule, and removes some of the capsule. Opening the capsule gives the implant more room to move around. In some cases, your surgeon will also remove your existing implant and replace it with a new one.

Q. What are the alternative treatments for Capsular Contracture?
Alternative treatments are not very common. In some cases an asthma drug can be prescribed, Accolate, for lower grade cases as it has anti-inflammatory properties.

Q. Who is at risk of capsular contracture?
Overall, the reasons that some individuals develop capsular contracture while others do not are not well understood. Dr. Cassileth is a firm believer in the “no-touch” method using a Keller Funnel to avoid any implant bacteria, avoid biofilm, and reduce the risk of infection.

Q. Can you have new breast implants after capsular contracture?
You can have new breast implants after capsular contracture, however it is important to note that the typical capsular contracture recurrence rate is about 50%. Dr. Cassileth developed a highly specialized surgical protocol resulting in a re-implant success rate of 98% on her patients.


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