How Does Capsular Contracture Occur?
One of the more common complications from breast implants is called “capsular contracture.” This condition often requires revision surgery to correct. It comes about through the development of too much scar tissue forming around the implant, leaving it constricted within the pocket, revealing the shape of the implant, altering the shape, or becoming hard. The traditional treatment for capsular contraction is to surgically remove the implant and excise the scar tissue.
Recent developments in breast surgery have revealed that ultrasound may be a more effective method to treat this uncomfortable and unsightly complication. We offer our patients this groundbreaking alternative to surgery.
Although it is most commonly associated with breast implants, capsular contracture can occur any time a capsule forms around a foreign object implanted in the body. Normally, the body reacts to a foreign object by forming a thin, soft, flexible layer of scar tissue around it. In cases of capsular contracture, however, the capsule becomes thick and hard, constricting and pulling on the surrounding tissue.
When capsular contracture occurs with breast implants, a breast that was once soft can begin to feel stiff and hard. As the condition worsens, the breast may become misshapen or hard and round against the chest. This complication can develop at any time, even years after breast implant surgery.
What Causes Capsular Contracture?
The exact causes of capsular contracture are still unknown to medical science. However, in a study published by the National Institutes of Health (NIH), researchers found evidence that submuscular placement (under the pectoral muscle), textured implants, and other surgical factors can significantly reduce the risk of developing capsular contracture. This study identified six factors associated with this common breast implant complication:
- Implant placement (above or below the pectoral muscle)
- Implant surface (smooth or textured)
- Incision site (increased odds with a periareolar incision, along the lower edge of the areola)
- Implant size
- Hematoma (swelling of clotted blood within the tissues) or seroma (pocket of clear fluid)
- Surgical bra (reduces the odds of developing capsular contracture)
How Does Ultrasound Treatment Work to Treat Capsular Contracture?
When the only alternative was once surgery, the option to treat capsular contracture without an invasive procedure is a very exciting development in aesthetics. The treatment is performed in our Seattle offices on an outpatient basis. It involves the use of soundwaves to trigger increased blood supply to the area, softening the scar tissue.
Ultrasound treatment for capsular contracture has several benefits, including:
- Improves natural lymphatic drainage
- Reduces edema
- Triggers the natural production of fibroblasts for natural healing
- Ramps up the speed of cellular regeneration
- Assists in the healing process
- Brings critical oxygen into the tissues
- Promotes new blood vessel regeneration
- Reduces inflammation
The ultrasound technique for treating capsular contracture has proven to be effective in preventing the onset of capsular contracture, and many women who have had implants take the step of avoiding the development of the condition with these treatments. While ultrasound can be a very effective treatment for existing cases of hardened scar tissue, it is also now used to help women who want to ward off the development of the condition. It is far more affordable than facing the prospect of undergoing revision surgery.
How Effective is External Ultrasound for Treating and Preventing Capsular Contracture?
When patients undergo surgery for capsular contracture to remove the implants and scar tissue capsule, the condition could potentially recur. External ultrasound is a non-surgical, well-tolerated treatment, free of any significant complications, known to achieve satisfactory results for many patients.
In a study published in the Aesthetic Surgery Journal involving 52 patients, repeat ultrasonic applications (ranging from two to 16 treatment sessions) produced:
- Overall improvement rate of 82.6% at one-year follow-up
- Positive difference in all patients
- Almost half of contractures reaching complete softness at one year
- Non-surgical ultrasound preventative treatments were performed by the same physicians on breast implant patients at:
- 7 days after surgery (when stitches are removed);
- 15 days after surgery; and
- 21 days after surgery
Patients who received these ultrasound assisted treatments experienced less swelling, bruising, inflammation, and post-surgical discomfort. Best of all, after a year and a half, none of the patients involved in the study had developed capsular contracture.
Post-Operative Treatment Protocol after Breast Implant Surgery
Allure Esthetic Plastic Surgery follows a non-surgical ultrasound assisted treatment protocol for capsular contracture prevention and treatment in patients with breast implants.
Breast Augmentation Ultrasound Prevention
This treatment is performed in two 30-minute sessions per week for three weeks, for a total of six treatment sessions to help prevent capsular contracture, at a cost of $400. The ultrasound device is set at 3 mhz to treat deep tissue swelling and assist with fluid removal.
Before the treatment is performed, ultrasound gel is applied. An ultrasound probe is used to massage each breast in a circular motion for six minutes. Each auxiliary lymph node is massaged in a circular upward motion for one minute.
Breast Augmentation Ultrasound Treatment
A package of 16 treatments is available for $500, delivered in two 30-minute treatment sessions per week for eight weeks. The number of treatment sessions needed will vary from patient to patient. Ultrasound settings are designed to assist in fluid removal, deep tissue swelling, and softening the scar tissue capsule and the breast.
As with preventative treatment, an ultrasound probe is used after ultrasound gel is applied. Again, each breast is massaged in a circular motion for six minutes and each auxiliary lymph node is massaged in a circular upward motion for one minute.
What Are the Stages of Capsular Contracture
The Baker grading system is used to measure the degrees of severity of capsular contracture:
- Grade I: Breast is soft and natural-looking.
- Grade II: Breast is slightly firm but still looks normal.
- Grade III: Breast is firm and looks abnormal.
- Grade IV: Breast is hard, painful, and abnormal-looking.
Who Is a Good Candidate for Non-Surgical Ultrasound Assisted Capsular Contracture Treatment?
External ultrasound has been used to successfully treat all stages of capsular contracture. It is also recommended as a preventative treatment following breast implant surgery, and as a pre-surgical treatment to improve the outcome of closed capsulectomy (surgical treatment for capsular contracture). After a consultation and careful evaluation, our acclaimed plastic surgeon at Allure Esthetic Plastic Surgery can tell you if non-surgical ultrasound assisted capsular contracture treatment is the appropriate treatment for you.