Capsular Contracture Prevention
Can I Prevent Capsular Contracture
The first thing to understand is that there is no way prevent capsular contracture. While there are things that can be done to reduce the risk, there is no foolproof way to guarantee successful prevention. That said, it doesn’t hurt to try, right?
Placement of breast implants above the muscle does appear to result in higher incidences of capsular contracture. Placing the implant beneath the muscle reduces this risk.
When saline breast implants are inserted via the areola incision, and a protective sleeve is not used, the implant passes through the milk ducts, which harbor bacteria. All silicone breast implants inserted via the areola route come into contact with the milk ducts, as protective sleeves cannot be used with prefilled breast implants. Contact with the bacteria in the milk ducts may increase the risk of capsular contracture. The crease, transaxillary, and TUBA incisions do now allow for passage of the breast implant through the milk ducts.
Smoking not only irritates nerve endings, it also constricts the blood vessels. If you smoke, it is best to quit at least 6 weeks prior to surgery, and for at least a few weeks after surgery. The constriction of blood vessels is not conducive to healing.
Avoid Things that Thin the Blood
Certain medications, vitamins and herbal supplements, and even alcohol thin the blood. When you’re just recovering from surgery, you certainly don’t want to thin the blood since you don’t want to risk excessive bleeding in the pocket. Should that happen, it could cause irritation and inflammation in the pocket, which puts you at a higher risk for capsular contracture.
Ibuprofen, aspirin, vitamin E, and fish oil are the most commonly ingested blood thinners. There are a wide range of medications that contain aspirin and ibuprofen. Prior to taking any over-the-counter medication, be sure to look at the ingredients to ensure that aspirin or ibuprofen is not listed.
With regard to herbal supplements, always consult with your surgeon in advance and let him or her know what you are taking, and whether or not it is safe to continue it up until surgery, as well as afterwards.
Alcohol is also a blood thinner, so abstaining from it during the early part of your recovery certainly cannot hurt.
Silicone Gel Breast Implants
Capsular contracture rates with silicone gel breast implants appear to be higher than their saline counterparts.
Some plastic surgeons routinely recommend massaging breast implants on a regular basis, some surgeons are ambivalent about it, and others discourage it, particularly if the implants are textured. Massaging smooth shelled breast implants helps to keep the pocket open, but there is no evidence that it reduces the risk of capsular contracture. Still, as long as your surgeon gives you permission to do it, it can’t hurt to try it.
Textured Breast Implants
Textured breast implants were created in hopes of reducing the incidence of capsular contracture. For some surgeons, the advantages of smooth implants far outweigh that of textured implants, with other surgeons preferring the textured surface.
In one study, 24 patients received smooth implants, and 26 received textured breast implants. All of these implants were implanted subglandulary (over the muscle). The women were evaluated at one year post-operatively. At that time, 15 of the 24 patients with smooth breast implants showed capsular contracture at Baker Grade III-IV, while only 2 of the 26 patients with textured implants fell into Baker Grade III-IV. At three years post-operatively, the women were evaluated again. A few of the patients were lost to the study at this point. Of the remaining study subjects, only 3 patients with textured breast implants had Baker Grade III-IV capsular contracture.
When textured breast implants are placed beneath the muscle, the differences in capsular contracture rates appear to be more negligible.
Compression Bras and Exercises
Prior to attempting any of the things listed here, you should consult with your plastic surgeon and get his or her permission, as you don’t want to do anything that would unintentionally harm you or cause problems during your recovery. That said, some women wear compression bras post-operatively. These bras are tight-fitting and compress the implant. In other words, the bras flatten the implant somewhat, thus making the diameter of the implant larger in the pocket. This is thought to help keep the pocket open and capsule enlarged. Other women opt for compression exercises such as lying flat on the floor on their stomachs. This compresses the implant a great deal. Another option is to use the palm of your hand to flatten the implant against the chest. This is performed as a variant of massage.
There are no studies that show that compression of any sort will prevent capsular contracture. However, if your surgeon says it won’t hurt you to try it, then you have nothing to lose.