Capsular Contracture Surgery by Anthony MacQuillan
Capsular Contracture surgery may be required to rectify a complication of Breast Implant Surgery.
Breast Augmentation with Implants, like any surgery, has risks and complications. Capsular contraction is said to affect anywhere from 10% to 20% of breast implant surgery patients.
After undergoing any type of implant surgery, it is common to develop scar tissue or capsules around the implant. It is a part of the healing process, and the tissue basically acts as a barrier to isolate the foreign body, in this case, an implant.
In most cases, this scar tissue is helpful in the Breast Augmentation recovery process. It helps to keep the implant in place, ensuring natural-looking results. However, in some patients, the scar tissue capsule becomes harder than it should, causing it to contract against the implant.
When capsular contracture occurs, it can alter the aesthetics of the breasts and occasionally cause pain. According to some research, one in six patients will experience some level of capsular contracture after undergoing Breast Augmentation.
What is a Capsulectomy?
If capsular contracture occurs, Plastic Surgeon Anthony MacQuillan can perform a surgical procedure known as a Capsulectomy that will remove the implant and its casing and restore a more pleasing, natural shape to the breast.
Capsulectomy is a surgery to remove the breast implant capsule that is required when the capsule starts to become thickened, hardened and/or contracts resulting in a change in shape of the implant, visible rippling of the skin and even pain.
The procedure is performed under a general anaesthetic, with an incision that is made in the most optimal place, either through your previous incision or in a position that scars will be well hidden.
During a Capsulectomy, scar tissue will be released, and the capsule and implant removed. Most patients will then have a new implant placed in the existing pocket or a new pocket made, and the incision is then closed with incisions. Recovery and possible complications are the same as after your initial Breast Augmentation procedure. You may have a partial capsulectomy or a full capsulectomy, depending on what is required.
2 to 4 hours
General
Day case
6 weeks
Results depend on techniques used and complexity and it can take a year before final results are visible.
Before & Afters
Benefits of Capsular Contracture Surgery
Undergoing Capsular Contracture surgery can offer numerous benefits, significantly improving the patient’s quality of life and satisfaction with their breast appearance. The advantages of this Capsular Contracture surgery extend beyond mere cosmetic corrections, including:
Physical Relief and Comfort
- Alleviation of Pain and Discomfort: One of the primary benefits of this surgery is the relief from chronic pain and discomfort caused by the tightened capsule.
- Restoration of Natural Breast Texture: Capsular Contracture surgery often restores the natural softness and suppleness of the breast, which can be compromised by capsular contracture.
Aesthetic Improvements
- Correction of Breast Shape and Symmetry: Surgery effectively corrects the distortion and asymmetry caused by capsular contracture, resulting in a more natural and aesthetically pleasing breast appearance.
- Improved Body Image: Successfully addressing the aesthetic concerns can significantly boost the patient’s self-confidence and body image.
Long-Term Outcomes
- Prevention of Recurrence: The surgical techniques employed aim to minimise the risk of recurrence of capsular contracture.
- Enhanced Durability of Implants: By addressing issues such as implant malposition or rupture, the surgery can potentially increase the longevity of the breast implants.
Psychological Benefits
- Emotional Well-being: Resolving both physical discomfort and aesthetic issues contributes to overall emotional and psychological well-being.
- Increased Satisfaction with Breast Augmentation: Patients who undergo this surgery often report higher satisfaction with their original Breast Augmentation or Reconstruction outcomes.
Personalised Care
- Tailored Surgical Approach: Each Capsular Contracture surgery is customised based on individual patient needs, ensuring optimal results.
- Comprehensive Follow-Up Care: Post-surgery, patients receive detailed guidance and support during their recovery, further enhancing the positive outcomes of the surgery.
Who Needs Capsular Contracture Surgery
Capsular Contracture surgery is a specialised medical procedure primarily aimed at individuals who have experienced complications following Breast Augmentation or Reconstruction surgeries. This condition arises when the fibrous capsule that naturally forms around a breast implant becomes excessively thick and tight, leading to aesthetic and physical discomforts.
Indications for Surgery
- Severity of Capsular Contracture: The need for surgery is often determined based on the severity of the contracture, which is typically classified using the Baker grading system. Grades III and IV, where the breast appears abnormal and is often painful, these are clear indicators for surgical intervention.
- Failed Non-Surgical Interventions: In some cases, non-surgical methods such as medication or physical therapy might be attempted initially. Surgery becomes a consideration when these treatments fail to alleviate the condition.
- Chronic Pain and Discomfort: Patients experiencing persistent pain, tenderness, or discomfort associated with capsular contracture are prime candidates for this surgery.
- Aesthetic Concerns: Significant distortion or asymmetry of the breast due to capsular contracture often necessitates surgical correction, especially if it impacts the patient’s self-esteem and quality of life.
- Implant Complications: Surgery may also be required if the contracture is accompanied by implant rupture, wrinkling, or displacement.
- Patient Assessment: Prior to deciding on surgery, a comprehensive evaluation is conducted. This includes a detailed medical history, physical examination, and possibly imaging studies to assess the extent of the contracture and the condition of the implants. This thorough assessment ensures that the surgery is tailored to the specific needs of each patient.
For more information on capsular contracture surgery, call 0117 325 5034 to arrange a consultation.
How is Capsular Contracture Surgery Performed?
Capsular contracture surgery is a complex procedure that requires precision and expertise. The goal of the surgery is to remove the hardened capsule and possibly replace or remove the breast implant. The surgical approach varies depending on the severity of the contracture, the condition of the implant, and the patient’s individual circumstances.
Preoperative Assessment
- Comprehensive examination and imaging are performed to plan the surgery.
- Anthony discusses the surgical options, including the possibility of changing the implant size, shape, or type.
Surgical Techniques
- Capsulectomy: This involves the complete removal of the scar tissue capsule surrounding the implant. It’s the most thorough option and is typically recommended for severe contracture cases.
- Capsulotomy: This method involves making incisions in the capsule to release tension. It’s less invasive than Capsulectomy but may not be suitable for all patients.
- Implant Exchange or Removal: Depending on the situation, the implant may be replaced with a new one or removed altogether. Newer implants with different textures or shapes might be used to reduce the likelihood of recurrence.
- Use of Acellular Dermal Matrix (ADM): In some cases, ADM is used to reinforce the tissue and provide additional support to the implant, enhancing the outcome of the surgery.
Procedure Steps
- Anaesthesia: The surgery is performed under general anaesthesia.
- Incision: Incisions are usually made in the same location as the original surgery to minimise additional scarring.
- Capsule Removal/Modification: The surgeon carefully removes or modifies the capsule, taking care to minimise damage to the surrounding tissue.
- Implant Management: Anthony either replaces the old implant with a new one or adjusts the existing implant.
- Closure: The incisions are closed with sutures, and drainage tubes may be placed to prevent fluid accumulation.
Postoperative Assessment
- The patient is closely monitored immediately after the surgery.
- The success of the Capsular Contracture surgery is evaluated through physical examination and, if necessary, imaging studies.
What Happens During Capsulectomy Surgery?
Surgery involves removing the current implants and carefully examining the inside of the capsule. If it is not too thick or hardened, it can be scored or hatched so that it stretches and new implants can then be inserted. However, if the capsule is distorted and hardened, it is necessary to remove it completely prior to inserting the new implants.
Capsular Contracture surgery is more involved and complex than Breast Implant Exchange and the biggest problem that is faced is bleeding into the implant pocket post-operatively. This is because when scar tissue is cut (and the capsule is essentially scar tissue) the blood vessels that would normally retract and seal off when cut are prevented from doing so and held open by the scar tissue, increasing the risk of a collection of blood forming around the implant (haematoma).
Anthony often uses surgical drains following Capsulectomy, in addition to meticulous attention to haemostasis (using electrocautery to seal any bleeding vessels), to minimise the risk of haematoma formation.
Recovery after Capsular Contracture Surgery
After surgery, you can undertake light activities (including light aerobic exercise) once you feel comfortable, and after the first two weeks, you can start to lift everyday objects. It is important not to do upper body weights or rigorous exercise until six weeks following the surgery. Your body will be a good guide as to what you can and can’t manage.
Although the success rate following surgery is high, there is a higher risk of redeveloping capsular contracture if you have had it occur once already. If this were to occur a further release of the contracture could be undertaken together with other potential steps to reduce the risk of recurrence.
The recovery period and aftercare are critical components in achieving the best possible outcomes from Capsular Contracture Surgery.
Immediate Postoperative Care
- Patients typically spend a few hours in recovery before being discharged.
- Pain management is a key focus, with medications prescribed to alleviate discomfort.
- Drainage tubes, if placed, are usually removed within a week.
Home Recovery
- Rest: Patients are advised to rest and limit physical activity, especially arm movements, to promote healing.
- Wearing a Supportive Bra: A surgical bra or a compression garment is often recommended to support the breasts during the healing process.
- Care of Surgical Site: Instructions on how to care for the incision site and recognise signs of infection are provided.
- Activity Restrictions: Heavy lifting and strenuous activities should be avoided for several weeks.
Follow-Up Visits
- Regular follow-up appointments are crucial to monitor the healing process and address any concerns.
Long-Term Care
- Patients are advised to perform regular self-examinations and schedule periodic check-ups with Anthony.
- Maintaining a healthy lifestyle and avoiding factors that can affect the integrity of the implants, like smoking, is recommended.
How Much Is Capsular Contracture Surgery in the UK?
The cost of Capsular Contracture surgery in the UK can vary depending on several factors, including the complexity of the procedure, the surgeon’s experience, the facility where the surgery is performed, and any additional services or procedures required. On average, Capsular Contracture surgery in the UK may range from £5,000 to £25,000.
To obtain an accurate price quote for Capsular Contracture surgery tailored to your needs, it’s recommended to schedule a consultation with a qualified plastic surgeon. During the consultation, the surgeon will assess your medical history, discuss your goals and expectations, and provide you with a personalized treatment plan, including a detailed cost breakdown.
FAQs
Find out more about your surgical journey
What is a Breast Implant Capsule?
Every breast implant develops a layer of tissue (or capsule) around it. It is the body’s way of trying to isolate the implant which it sees as a foreign body.
This is entirely normal and it is this reaction to foreign material that allows hip replacements to work so well (by forming a new joint capsule).
Normally the process of capsule formation goes unnoticed by both patient and doctor and no action is required. Occasionally, however, problems can arise where the capsule starts to become thickened and contracts resulting in a change in the shape of the implant, visible rippling of the skin and even pain due to the forces exerted on the soft tissues by the capsule.
What causes Capsular Contracture?
The exact cause of capsular contracture isn’t known. Some experts believe there may be a genetic link, while others think it could be down to a type of bacteria which is introduced into the breast cavity during the surgery. The bacteria can lead to a mild infection, where excess fibrous tissue is created before it hardens around the implant.
When capsular contracture occurs, it can alter the aesthetics of the breasts, and occasionally cause pain. According to research, one in six patients will experience some level of capsular contracture after undergoing Breast Augmentation.
Whatever the cause or concern, if you do develop capsular contracture, patients do have treatment options available to rectify the condition.
How can you avoid Capsular Contracture?
As the exact cause of capsular contracture isn’t known, and as it does appear to occur randomly, preventing the condition isn’t always possible. That being said, there are ways to lower the risks.
Tissue trauma and bleeding during the procedure are known to increase the risk of the condition. Therefore, making sure you choose an experienced and highly skilled surgeon is of paramount importance. If bleeding does occur, the surgeon will need to remove the blood before closing. If they don’t, the old blood can cause scar tissue to harden.
Some studies have shown giving the patient antibiotics prior to Breast Augmentation can reduce the risk of bacterial infection. Patients should also ask the surgeon what steps they will take to prevent the risk of capsular contracture caused by infection.
Surgeons should also avoid taking the implant out numerous times in order to position it. This will cause excessive trauma to the surrounding tissue, greatly increasing the risk of capsular contraction.
There is also evidence to suggest that the placement of the implants is important in prevention. Implants which are placed under the muscle have shown to be a lesser risk for the development of the condition.
Capsular contracture is a relatively common problem faced by Breast Augmentation patients. While there are ways to reduce the risks, avoiding the condition completely may not always be possible. It is a good idea to talk to Anthony about the risks and what are your options if you do develop capsular contracture.
What are the risks and potential complications of Capsular Contracture Surgery?
Like any surgical procedure, Capsular Contracture Surgery carries certain risks and potential complications. It’s important for patients to be aware of these to make informed decisions.
Common Risks:
- Infection: Despite sterile techniques, there’s always a risk of infection, which might require antibiotics or additional surgery.
- Bleeding and Haematoma: Bleeding can occur during or after surgery, potentially leading to a haematoma that may need to be drained.
- Scarring: Surgery can lead to scarring, although incisions are typically made in less visible areas.
- Changes in Breast Sensation: Some patients may experience temporary or permanent changes in nipple or breast sensation.
Implant-Specific Complications:
- Implant Rupture or Leak: New implants can rupture or leak, although this is rare with modern implants.
- Implant Displacement: There’s a possibility of implant shifting or displacement, requiring further surgery.
Long-Term Risks:
- Recurrence of Capsular Contracture: There is a chance of recurrence, especially if contributing factors are not addressed.
- Anaesthesia Risks: As with any surgery under general anaesthesia, there are risks associated with anaesthesia.
Preventive Measures:
- Choosing a skilled and experienced surgeon.
- Following all preoperative and postoperative instructions carefully.
- Regular follow-ups for early detection and management of any complications.
Medical References about Capsular Contracture Surgery
- What is capsular contracture and how can it be treated? – American Society of Plastic Surgeons
- Capsular Contracture after Breast Augmentation
- Advances on Capsular Contracture—Prevention and Management Strategies
- Risk factors for developing capsular contracture in women after breast implant surgery
- Surgical Treatment of Capsular Contracture (CC)
Reviews
Patient satisfaction is the top priority for Anthony. You can find how patients feel about his work below.
Much Needed Breast Replacement – Sorted by a Fabulous Surgeon. Bristol, GB
Having researched and visited some cosmetic surgery providers in my area, I made an appointment with Anthony MacQuillan from The Spire’s team of experienced plastic surgeons. From my first consultation, I realised that he was a perfectly sound choice.
He carefully read the report from Southmead Hospital’s MRI scan of my breasts, which demonstrated a left and possibly right breast intracapsular rupture. My lymph nodes also contained silicone from the gel implant leak. With a kind, unrushed and approachable manner, he addressed all my concerns (no matter how daft). He asked me about the look I wanted to achieve and addressed the different options I was considering. I’m 54 and was hoping for a more natural look so was asking about different more natural shapes, maybe a smaller size etc. He offered great advice and gave me all me the pros and cons about these options. He gave me clear information about the procedure, about the implants he uses, and was completely transparent about the risks involved. He even addressed the fact that my breasts were asymmetrical (a problem I was told could not be addressed by another company) and he felt something could be done about that too.
I left the appointment feeling like a weight had been lifted from my shoulders. Mr MacQuillan had taken my problem on board like a true professional and made it HIS problem! I felt supported, encouraged, answered and confident. Any mysticisms surrounding the procedure had been expelled.
We met twice prior to the operation, the second so that I would have had time to absorb the information from the first, address any further questions I had etc. I was offered further pre-op appointments if needed however, and was totally unhurried – how refreshing!
I was worried about the operation as I had only been under once before (for the first implants). I knew Mr MacQuillan only had sketchy information from my MRI scan results about what he would be dealing with. Again, he gave me courage and completely reassured me.
Everything went well. I cannot rate Mr MacQuillan and his abilities highly enough – he is amazing. It was a longer procedure than predicted as my gel implants were in rather a bad state and Anthony took a great deal of care in removing them, cleaning out the pockets of any silicone, and replacing them with new Natrelle 410 implants under the muscle as before. It was considerably less painful than the first augmentation as Anthony had indicated – and my recovery has been without complications.
I am delighted with the results – my breasts are softer, look more natural and – yes – now pretty much aligned! Since my op, I’ve had 2 follow ups so far. I also feel completely confident that I can contact him easily through his efficient secretary Margaret at any point should any issues arise because of their unique aftercare programme.
Utterly Flawless Throughout!
After 12 years and 2 children I wanted my breast implants removed (& was aware I would need an uplift!). I saw 3 surgeons: 2 just told me to replace the implants and really didn’t understand that I did not want to do that but wanted to remove them-both told me I would be left with barely any size if I did that and didn’t give me another option. I didn’t feel either were particularly concerned with MY desires and were very dismissive. Then I met Anthony-after a lot of careful research on the internet. What a charming, caring, lovely man. I had 2 lengthy consultations where I asked so many questions and not once did I feel rushed or silly for asking anything that seemed obvious. He clearly outlined all risks anddusnt sugar coat anything. He told me it was completely possible to remove the old implants and uplift but gave me the added option of a fat transfer from tummy (great!) to breasts. He said he couldn’t guarantee the size would stay but it really has. They look better than before I had implants initially and they look better than with implants even. They are perky, full and I couldn’t be happier! The scars are barely noticeable and it’s only been 6 months. The care straight after the operation by all nursing staff was flawless as was the aftercare from Anthony. I haven’t had any complications and all my questions have been attentively answered. I couldn’t be happier and he is the only, only surgeon I would choose to return to in the future should I want to have more surgery one day. Price wise I felt the costs were very reasonable considering the multiple skills required in this surgery. I would not hesitate to recommend this amazing surgeon. So happy thank you!
Why Choose Anthony?
Anthony’s expertise in Breast surgery is complemented by an all-inclusive approach to patient care. We understand the importance of listening to your concerns, desires, and expectations, ensuring a journey that is as comfortable and reassuring as possible. From the initial consultation through recovery, our team is dedicated to supporting you every step of the way.
State-of-the-Art Techniques and Facilities: We use the latest surgical techniques and technologies to ensure optimal outcomes and minimal downtime.
Personalised Care: Each procedure is tailored to meet the individual needs and goals of our patients, ensuring results that are both beautiful and natural-looking.
Comprehensive Support: Our team provides comprehensive care, from pre-operative education to post-operative support, ensuring your experience is positive and fulfilling.
Getting Started
Your journey toward confidence and well-being begins with a consultation. During this meeting, Anthony will discuss your aesthetic goals, evaluate your health, and recommend the best treatment options for you. Together, we will craft a personalised plan that aligns with your vision and lifestyle.
To learn more about our procedures or to schedule your consultation, please contact us today.
Further Reading about Breast Surgery with Consultant Plastic Surgeon Anthony MacQuillan
- Breast Implant Removal
- Breast Reduction
- Breast Augmentation
- Breast Implant Revision
- Breast Uplift – Mastopexy
