Capsular contracture is a hardening of the scar tissue that forms around a breast implant after a breast augmentation; it can cause distortion of the breast and can sometimes even be painful. Fortunately, the vast majority of patients don’t experience a capsular contracture following a breast augmentation, but for those patients who do it can be miserable, and be a need for more surgery.
Thankfully the rate of capsular contracture following breast augmentation has decreased over the years, as our understanding of capsular contracture, and our techniques have improved; however, capsular contracture still remains a pesky problem. There is some good news though! Thanks to the work of Dr. David Hildago, and others, we now have confirmation of something we have suspected for many years: the use of acellular dermal matrices (ADMs), is a very, very good way of preventing capsular contracture from recurring in patients who have had a capsular contracture removed!
Typically when patients have a capsular contracture, a firm or hard breast, they will undergo surgery to remove the capsule and place a new implant. Unfortunately, about 30% of these patients will develop a hard breast again, in other words, they will develop a second capsular contracture and require a third surgery to remove this capsule. But now there is help: ADMs. In fact, ADMs are now recommended for patients who have developed a second capsular contracture. During the surgery the capsule is removed again, a new implant is placed but this time the implant is covered with the acellular dermal matrix. The ADMs work very well and prevent recurrence of a hard capsule in over 90% of patients! So if you have already had a hard capsule removed and you have developed another hard breast you should speak with your surgeon about using an ADM so you don’t develop another capsular contracture.
Not only are AMDs good at preventing capsular contracture, but they are also very helpful, especially for very thin women, as the ADM will improve the thickness of the soft tissue over the implant and help conceal the implant. Sometimes fat is also added over and around the breast implant if the patient has any fat to use.
ADMs are a very good, safe treatment for recurrent capsular contracture and I suggest it to my patients who have had previous capsular contracture, or for those patients who develop capsular contractor in both of their breasts right from the very beginning.