The encapsulation or capsular contracture of breast prostheses is one of the biggest concerns of any woman who wants to perform a breast augmentation. The risk certainly exists, but we must be aware that it happens in less than 5% of cases.

The first thing to be clear is that around all implants a capsule is formed naturally. The formation of this capsule is a normal reaction of our system to a foreign body (in this case the implant). To protect it creates a fibrous layer that we must take into account during the healing process.

The silicone implant does not pose any risk to the health of the patient, this material is used because it does not interact or produce rejection. When the capsule is formed around the prosthesis (periprosthetic capsule) it adheres better to the tissues of the breast, fills the spaces and helps to prevent infections.

The difference or the problem comes when this capsule compresses the mammary prosthesis, giving rise to a contracture or pathological capsule. This occurs when the fibrous capsule is irregular, thicker than normal, too firm and smaller than the prosthesis.

We must also distinguish between the encapsulation after surgery, which occurs in the first months after the implant, from the late encapsulation that happens many years later when the useful life of the prosthesis is completed and a replacement or withdrawal is necessary, this does not occur either in all cases.

Postoperative encapsulation

The postoperative encapsulation of breast implants today occurs infrequently, but if it occurs, in most cases it is a gradual process that we detect within a few weeks.

The compression exerted by the capsule causes the prosthesis to become more rigid and at the same time to pull the surrounding tissues. This can cause a displacement of the prosthesis several centimeters and give rise to a ball effect that can be seen with the naked eye.

The most delicate period of time is the first three months. We must put into practice all the recommendations of the plastic surgeon to reduce as much as possible the risk of encapsulation. After the first six months it is very unlikely that there will be a capsular contracture.

If we have any suspected symptoms, we should not act on our own. Nowadays we use the internet for anything and for example in the case of capsular contracture massages we must start when the plastic surgeon considers that the wound is quite closed and the patient does not suffer too much discomfort.

Causes of capsular contracture

The causes of capsular contracture can have different origins. These may be due, for example, to medical factors such as the surgeon’s technique or skill, the level of hygiene during the procedure, the placement of the prosthesis (under the gland or behind the pectoral muscle) or the implant cover (smooth, textured , ultratexturized …).

The cause of the encapsulation can also be related to the patient, either for not following the medical advice, for example if he does not maintain the postoperative rest or does not perform the prescribed massages, or for having a certain predisposition to this complication (poor quality of skin, tuberous breasts, etc.).

In addition, a capsular contracture may develop for other reasons that are not medical or patient fault. They are simply unpredictable postoperative complications, which we know can happen and we can not always avoid them. We speak for example of hemorrhages, bruises, infections, seromas, among others.

Treatment of capsular contracture

If we detect the symptoms of capsular contracture the treatment should be indicated by your plastic surgeon. To give you a more precise idea, you should know that in the first place we choose solutions without surgery such as massages, which can be very effective if the guidelines are followed.

If non-invasive treatments do not achieve the desired result, a surgical solution such as capsulectomy should be chosen. In it we remove the capsule without replacing the implant (unless necessary), so that a new capsule is formed. This option is usually very effective and can even be repeated, but it should also be performed by a specialist in Plastic Surgery.

Ultimately, when the above options have failed and the aesthetic result is not what is desired, we can resort to more complex surgeries such as modifying the implant placement plane or choosing an implant with a different cover. These are issues you should discuss personally with the plastic surgeon.

We can summarize all the above clarifying that nowadays breast augmentation is one of the most frequent cosmetic surgeries in Spain. Although it implies risks inherent in any surgical procedure with implants, when we put ourselves in the hands of a specialist in Plastic Surgery the results in the vast majority of cases are usually a success and provide great satisfaction to the patient.

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