CAPSULAR CONTRACTURE REPAIR

TO FIX CAPSULAR CONTRACTURE, THE SURGEON MUST ADDRESS THE REAL PROBLEM

WHAT IS CAPSULAR CONTRACTURE?

Capsular contracture is a relatively common condition that sometimes occurs after breast augmentation. It is one of the most common complications following breast augmentation, ranging from 2.8% to 20.4%1. Capsular contracture can cause breasts to raise, to become distorted, or makes them painful and hard to the touch.

A capsule is the normal tissue that the body produces surrounding a breast implant. Usually, it is pretty thin, sometimes almost transparent. The capsule should be larger than the implant, allowing the implant to move around inside the capsule pocket. But in capsular contracture, the capsule becomes thicker, and gets tighter, which makes the space for the implant smaller and smaller. As the capsule tightens, the implant rises to a higher position on the chest, making the breast look tight and artificially round, like a baseball. The capsule can get so small that the implant feels quite firm (grade 3 capsular contracture). It can even feel hard and be painful (grade 4 capsular contracture).

Traditional methods of correcting capsular contracture often result in recurrence, but our surgeons have created techniques to solve capsular contracture, resulting in a cure rate of over 95%.

Before & After

Browse our photo gallery to see the real-life difference our capsular contracture treatment can make.

Before & After Photos
Before & After Photos
Before & After Photos

WHAT CAUSES CAPSULAR CONTRACTURE?

Capsular contracture is caused by anything that leads to inflammation of the capsule, which causes the capsule thicken and tighten. The cause of capsular contracture varies from patient to patient, and more than one cause may be present in one person. Common reasons include trauma or bleeding around the implant from the initial surgery, bacterial infection and biofilms (a film of cells that grow on inert surfaces), ruptured silicone or remnants of silicone from an old rupture, or patient reactivity to a foreign body. We are finding that biofilms are more frequently the cause of contracture than initially thought, with as many as half of all contractures associated with biofilms.

Imagine the capsule as a net that contracts and tightens. If the inflammation doesn’t go away, or gets worse over time, the net gets tighter and tighter. Eventually, the net shrinks to the same size as the implant, trapping the implant so that it can no longer move within the net, and it becomes hard and immobile.

Dr. Cassileth
Breast Specialist

Board-Certified Beverly Hills Plastic Surgeon, Breast Specialist, and Direct-to-Implant Breast Reconstruction Inventor

American Society of Plastic Surgeons
American Board of Plastic Surgery
American College of Surgeons
The Aesthetic Society
Dr. Cassileth

PREVENTING CAPSULAR CONTRACTURE FROM REOCCURRING

How we obtain our 95% + cure rate:
  1. Remove the affected implant and capsule
  2. Create an internal bra
  3. Treat all biofilms for complete eradication

1. REMOVAL OF THE IMPLANT AND CAPSULE.

Capsular contracture can only be cured if your entire capsule is removed.

During the capsular contracture surgery, we carefully remove the complete capsule. This can happen with the entire implant still inside the capsule, called “en bloc” capsulectomy, or the capsule can be removed after the implant, called “complete capsulectomy.” The removed capsule is biopsied and sent to a pathology lab to test for biofilms, which are low-grade bacteria that live on the surface of the implant and can cause contracture. We then look for any adjacent silicone leakage or other abnormalities in the surrounding breast tissue. All abnormal tissue must be removed, but all normal breast tissue should be preserved. Next, we use an antibiotic power-wash to combat potential sources of infection, including biofilms. Finally, an anti-bacterial solution is left within the breast, to complete the eradication process.

Dr. Killeen

Dr. Killeen
Breast and Body Plastic and Reconstructive Surgeon

Double-Board-Certified Beverly Hills Plastic Surgeon and Breast & Body Specialist

American Society of Plastic Surgeons
American Board of Plastic Surgery
American College of Surgeons
The Aesthetic Society

In your initial consultation, we will determine your likelihood for carrying a biofilm. Biofilms are much more likely to be present in patients with capsular contracture2 . Likely biofilm carriers are: unilateral contracture patients (only one side affected); patients who had contracture following breastfeeding; patients with a low-grade infection following their initial augmentation; and patients who have contracture following dental cleaning or illness. Biofilm carriers may be more likely to have Bii (Breast implant illness).

2. THE INTERNAL BRA.

Once the implant and capsule have been removed, our doctors create an internal bra with acellular dermal matrix (ADM), a biomaterial sheeting, which resists contracture and provides a protective layer between the breast and the implant. The ADM allows the body’s natural reaction to occur: a healthy capsule can form and fuse with the ADM, keeping the pocket soft and pliable. It also supports the implants and keeps your breasts in the ideal shape and position. The presence of the ADM further decreases the recurrence rate.

DR. MIN
Breast Specialist

An Ivy-League-Trained Plastic Surgeon Specializing in Breast and Body Procedures in Los Angeles

Dr. Min

3. TREAT ANY INFECTION.

After your procedure, you will be kept on antibiotics until the biopsy test results are received from the lab. If bacterial growth is detected, we will send you for a consult with an Infectious Disease specialist. You will begin a course of antibiotics tailored to the results of your microbiology tests. If your results are negative (no infection), you will undergo a shorter course of prophylactic antibiotics. Patients at high risk of biofilm, those with unilateral contracture, for example, are often kept on a one-month course of antibiotics as it is common to receive positive test results for biofilms two and even three weeks after the surgery.

THE RESULTS.

Our care rate is over 95%, thanks to our through approach to treating all aspects of contracture. There is a one-week recovery period, followed by a full month of restricted exercising after surgery. After one month, we allow you to resume all activities. We ask that you avoid underwire bras for around three to six months after surgery, in order to allow the breasts to relax into the proper position.

Capsular Contracture Treatment Video


1Archives of Plastic Surgery. Capsular Contracture after Breast Augmentation: An Update for Clinical Practice. Available:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579163/. Accessed February 8, 2021. 2Aesthetic Surgery Journal. The Relationship of Bacterial Biofilms and Capsular Contracture in Breast Implants. Available:
https://academic.oup.com/asj/article/36/3/297/2589255. Accessed February 8, 2021.
Cassileth Plastic Surgery & Skin Care

Contact Cassileth Plastic Surgery about capsular contracture in Beverly Hills to set up a meeting with one of our plastic surgeons. Send a message online to arrange a consultation, or call (310) -278-8200.

Patient Testimonials

Anonymous
Anonymous' Story

Dr. Kelly Killeen is not just an outstanding surgeon and artist, she is also an angel. I had 15+ surgeries to correct an ongoing problem for last 10 years, numerous super-famous doctors worked on me, in different parts of the world, including Geneva, Berlin, etc.. So by the time I got into Dr. Kelly's hands the words "total mess" don't even begin to describe the actual condition of what used to be my breasts. Dr. Killeen, just as regular angel performed a miracle and made everything good again. I love you. There is also nurse Dee who is just incredible human being, here level of compassion, love and care is truly rare. Last but not the list there is a Brit called Jade - she is so beautiful, funny and totally awesome, I will find a reason to come again for some facial peeling or something else simple just to see you guys! I am so blessed to have met these beautiful people, they maybe just part of exceptional medical team, but in my heart they will always be my friends...

Cassileth Plastic Surgery & Skin Care

Arrange a consultation for capsular contracture treatment at Beverly Hills' Cassileth Plastic Surgery. Women from Santa Monica, the entire Los Angeles area, and beyond can Send a message online or call (310) -278-8200.

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