Most women never have complications with their breast augmentation or implants. At his Orange County practice, Dr. Andrew Smith specializes in making things right for those women who do experience problems, such as capsular contracture. This is when the normal capsule of scar tissue around the implant begins to harden and contract, often squeezing and displacing the implant. It is the most common breast augmentation complication, and can cause visible deformity and discomfort.
When you’re experiencing any breast augmentation complication, it’s especially important to choose your surgeon carefully. Dr. Andrew Smith has years of experience performing complex revision procedures for Riverside and Orange County breast augmentation patients whose implants need correction.
Request a FREE surgical consultation online to meet with Dr. Smith at one of his 3 locations. You can also call his office at (949) 653-7000 to schedule an appointment.
When you choose Dr. Smith, you’re choosing a breast specialist who
- Is the Chief of the Subsection of Plastic Surgery at Saddleback Memorial Medical Center
- Is one of the top surgeons in Orange County for complex breast revisions and reconstructions
- Has performed thousands of breast surgeries during his 15+ years of surgical experience
What is capsular contracture?
After breast augmentation surgery, the body naturally creates a thin layer of tissue around the implants. This tissue, called the capsule, varies in consistency between patients and even between each of a patient’s breasts. In cases of capsular contracture, the tissue thickens and tightens around the implant causing discomfort and a distorted breast appearance.
Before & After Photos
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Case 208, Breast Revision
This is a 46 year old female who is 5’7 and weighs 147 pounds. She came to Dr. Smith wanting to remove her 20 year old implants and replace them with a similar size implant. She was also unhappy with her excess fat and skin around her waist and abdomen. However she wasnt ready to have a scar from a tummy tuck yet. So Dr. Smith removed her old implants and replaced them with 339 silicone gel implants on the right and left side. He also did liposuction on her abdomen and waist. She is very happy with her results.
Case 157, Breast Augmentation, Breast Revision
40 year old female who had a previous breast augmentation and was very unhappy with her result. She had a saline subglandular augmentation and her implants have resulted in severe rippling and her implants have ended up under her arms. She has a lack of central fullness and her implants end up on her side when she lays down. We did a breast augmentation revision with a complex surgical approach. A switch to larger silicone gel implants along with a pocket change to subpectoral was done. The pocket change utilized AlloDerm® dermal matrix to define the pocket and reduce rippling postoperatively. This resulted in a dramatic improvement and has almost completely eliminated her rippling….
Case 160, Breast Augmentation, Breast Revision
27 year old female from Riverside County who had a previous breast augmentation procedure and developed a “double bubble” or loosening of the inframammary fold. This also resulted in visible rippling at the top of her breasts even though her implants were under the muscle. She had saline implants in place, and was satisfied with her volume, but wanted her breast folds and rippling to be improved. We did a breast revision in our Orange County surgical center for her to re-establish her inframammary folds. This consisted of a capsulorraphy (pocket sutures) on both sides to elevate the fold of her breasts and correct her breast augmentation. She chose to keep her existing saline impla…
Case 196, Breast Revision
This 48 year old female had a previous augmentation 17 years ago. She had severe encapsulation of bilateral breast implants with grade IV capsular contracture.
Dr. Smith preformed a bilateral breast complete capsulectomy with ruptured implant removal and replacement with new silicone implants.
Case 222, Breast Augmentation, Breast Revision
This is a 40 year old female who had a previous breast augmentation 13 years ago and wanted to have her implants changed. She wanted to stay about the same size or slightly smaller. We took her old implants out and replaced them with 339 silicone gel implants on the right and left side.
Case 213, Breast Augmentation, Breast Revision
This is a 35 year old female from south Orange County. She had previously had a breast augmentation years ago with saline implants. Her right breast implant had ruptured. She wanted to be similar in size but wanted to have silicone gel implants instead. We put in a 339cc silicone gel implant on the right side and a 304cc silicone gel implant on the left. She is very happy with her results.
Case 187, Breast Augmentation, Breast Lift, Breast Revision
This 49 year old Orange County woman removed her old implants and replaced them with new 225 cc silicone implants. Her old implants were encapsulated so she had a capsulectomy and a lift at the same time.
Case 257, Breast Augmentation, Breast Revision
This 34 year old female had a saline implants placed under the muscle approximately 8 years ago. She came into see us because her left breast implant had ruptured. She is a 32 D and would like to remain about the same size. She is 5’1 105 pounds. Using an inframmammry fold incision we placed 425 cc silicone implants under the muscle.
Case 295, Breast Revision
This is a 47 year old female who was interested in a breast revision. She has had multiple previous breast augmentation procedures including a breast lift. She has breast asymmetry with a right-sided encapsulation. She feels that her breasts are too large and wants to downsize her implants. She preceeded with a breast revision which included a right breast capsulectomy, right breast Alloderm graft, and bilateral mastopexy revision. She was placed with Natrelle style 15 265cc silicone implants. She is very happy with her results.
See More Before & After Photos
What causes capsular contracture?
Capsular contracture can affect one or both breasts. Most cases occur within a few weeks to a year of the original surgery; some cases occur years later. The cause of capsular contracture remains unclear. The condition is thought to be an immune system response in which the body rejects the implant and forms a barrier around it. The following risk factors are associated with capsular contracture:
- Bacterial contamination of the implant
- Breast infection
- Ruptured implant
- Build-up of blood around the implant (hematoma)
- Subglandular placement of the implant
How can it be prevented?
It’s difficult to predict who will be affected by capsular contracture. Because the cause of capsular contracture isn’t entirely clear, it can’t be completely prevented. The chances may be greatly reduced when your surgery is performed by an experienced, board-certified plastic surgeon. The following factors have been found to minimize the risks:
- Washing the breast pocket and implant with an antibiotic solution
- Placing the implants under the chest muscle
- Using textured implants
- Choosing cohesive silicone gel implants over saline or other types of silicone
- Inserting the implants without direct contact using the Keller Funnel™
- Performing implant massage after surgery as directed
- Taking oral antibiotics after the breast augmentation procedure and prior to any dental surgery
What are my treatment options?
In general, capsular contracture must be corrected with surgery. Dr. Smith will recommend the method that will provide the most attractive results and minimize the possibility of recurrence. Options include:
- Performing a capsulotomy to release or remove a portion of the thickened capsule
- Performing a capsulectomy to surgically remove the thickened capsule
- Reinforcing the implant pocket with an acellular dermal matrix
Most women opt to exchange their implants when they undergo capsular contracture surgery, however some women choose to have them removed and not replaced. In either case, revision surgery is more complex than the initial breast augmentation, and recovery may be slightly longer.