Capsular contracture occurs when the scar tissue around the implant pocket becomes too thick, eventually leading to misshapen, painful breasts. Studies have suggested that a low-grade infection is one of the triggers leading to this complication, which requires a revision that always requires replacement of implants.
1. Breast implants. Some studies have suggested that gummy bear implants (fifth generation silicone implants) and textured implants could reduce capsular contracture rate.
Gummy bear implants, because their filler material is extremely cohesive, have been known to drastically reduce the risk of rupture, which is tied to capsular contracture believed to be an over-reaction of the body to fight off minute leak and low-grade infection.
2. Breast implant massage. Dr. Smaili typically advises his patients to begin implant displacement exercise a week after surgery to maintain the natural softness of the tissue and pocket, thereby potentially preventing capsular contracture. This postop care is also known to accelerate the settling of implants into their proper place, leading to a more teardrop appearance.
3. Submuscular. Placing the implants under the muscle, as suggested by several studies, can reduce the complication rate by as much as 20 percent. The idea is to position the prostheses in a way that there is no contact with the breast tissue known to harbor staph bacteria, which can trigger capsular contracture.
4. Asthma medications (Accolate). A small study involving patients with first stages of capsular contracture who were asked to take these drugs has shown that such treatments can soften the breasts in three to six months.
The theory is that these medications prevent the body to overreact from the presence of breast implants, the same way it works to relieve asthma.
5. Sterilize everything. Contamination around the implant shell is believed to be a common trigger of capsular contracture and a wide range of complications. For this reason, it is crucial to sterilize the surgical facility, equipment, implants, and even the pockets where they will be positioned at the time of surgery.
To further minimize the risk of infection and capsular contracture, many reputable plastic surgeons, including Dr. Smaili, uses the no-touch technique in which the implants are opened only at the moment of implantation, and positioned into the pocket with the use of a cone-shaped device called Keller Funnel that is squeezed rapidly.