Can you get capsular contracture in just one breast?: 10 Capsular Contracture FAQs, Answered
Capsular contracture is the most common complication that affects patients who have breast implants, and the condition varies widely in the impact it can have on the breasts’ look and feel. Here, Dr. Sharline Aboutanos, a Richmond plastic surgeon, answers frequently asked questions about capsular contracture and offers insights into how you and your surgeon can reduce your risk.
Can you get capsular contracture in just one breast?
Yes, capsular contracture can occur in just one breast. The condition is caused by an excessive tightening and thickening of the scar tissue (capsule) that naturally forms around an implant. Because each side of the body heals independently, it’s not uncommon for only one side to be affected. In cases where it develops in both breasts, the degree of severity can also differ between the two.
Is capsular contracture painful? Where do you feel pain?
Capsular contracture can be uncomfortable or painful in more advanced stages. We classify the capsular contracture by grade:
Grade I: The breast looks and feels normal.
Grade II: The breast feels somewhat firm but appears normal.
Grade III: The breast is noticeably firm and looks unnaturally shaped.
Grade IV: The breast is hard, painful, looks abnormal, and may sit unnaturally high on the chest.
Grades I and II aren’t likely going to cause any discomfort. For grade III or grade IV capsular contracture, the discomfort typically manifests as a tight or squeezing sensation in the affected breast. In rare, severe cases of grade IV, the pain may extend to the chest wall or ribs.
What are the first signs of capsular contracture?
The earliest signs of capsular contracture are changes in the feel or shape of the breast—usually within 6-12 months after breast augmentation. You may notice that one breast becomes firmer than the other or that the implant starts to sit higher on the chest. If the condition progresses, tightness, discomfort, or visible distortion may develop. It is very unlikely that you will experience the onset of capsular contracture after two years.
Can the type of implants increase or decrease your chances of getting capsular contracture?
Yes, the type of implant can influence your risk of developing capsular contracture. Textured implants are generally associated with a slightly lower risk compared to smooth implants; however, heavily textured implants fell out of favor with many plastic surgeons after Allergan recalled their Biocell macro-textured implants due to a possible link between the implant surface and Breast Implant-Associated Anaplastic Large-Cell Lymphoma (BIA-ALCL) in 2019. That said, patients who choose smooth implants for their breast augmentation have only a very small risk of experiencing any degree of capsular contracture, especially when they choose a breast surgery specialist like Dr. Aboutanos.
How do you treat capsular contracture?
How we treat capsular contracture depends on the severity. Advanced stages that affect your appearance or comfort often require surgical intervention to address the issue: capsulotomy (releasing the tight scar tissue) or most commonly a capsulectomy (removing the scar tissue). During a capsulectomy, you may choose to have new implants placed or return to your natural breast size. Patients who do not wish to replace their implants may benefit from adding a breast lift to their procedure plan to reshape and tighten stretched tissue caused by significant weight fluctuations.
“Dr. Aboutanos is nothing short of stellar. She listens, is caring and patient. She is the gold star model of excellence!! Her work is amazing from surgical to non-surgical. She gave body confidence and acceptance back to me with her talents. If you are new to cosmetic surgery and/or nervous, please hire Dr Aboutanous. You are in safe hands with someone who has integrity, openness and patience. Just follow her care plans to a T and I promise you, the cost will be worth it!”
—5-star Google review
Can you massage capsular contracture away?
Massage is unlikely to resolve an existing case of capsular contracture, even though it can help keep scar tissue soft and flexible in the early healing stages after surgery. In fact, improper massage could exacerbate discomfort or complications, so it is imperative that you follow Dr. Aboutanos’ post-operative care instructions carefully and ask for guidance if you have any questions about the protocols.
Can capsular contracture rupture an implant?
Capsular contracture does not directly cause an implant to rupture, but the excessive pressure from the tightened scar tissue capsule can contribute to wear on the implant shell over time, which may eventually lead to implant rupture. If your implants are at risk for rupture, be sure you choose a plastic surgeon who is highly experienced in breast implant removal procedures so this issue is fully resolved and you are happy with your breast appearance after surgery.
What happens if you don’t treat capsular contracture?
Untreated capsular contracture may worsen and require surgical correction; most cases of capsular contracture do not require surgery. If more severe grades are left untreated, capsular contracture may worsen, causing more discomfort and visible distortion. An early diagnosis and timely intervention make capsular contracture easier to treat, so patients are encouraged to keep their plastic surgeon informed of any unexpected breast changes, especially during the first year after breast augmentation.
Dr. Aboutanos sees all plastic surgery patients at key points in their recovery process to monitor their progress and confirm they are healing as expected.
Will I get capsular contracture again if I replace my implants?
There is a possibility of capsular contracture recurring after implant replacement, though the risk is not significantly higher compared to primary breast augmentation. If you have certain risk factors that make you prone to capsular contracture, such as radiation exposure or a family history of autoimmune diseases, you should discuss your options with a surgeon you trust. Dr. Aboutanos thoroughly discusses your medical history and family history to ensure you can make an informed decision about your care.
Can capsular contracture be prevented?
It’s impossible to guarantee prevention, but choosing a board-certified plastic surgeon who stays up-to-date on the latest scientific research and techniques to lower the risk of capsular contracture is the bedrock of your safety. Dr. Aboutanos uses several strategies to further reduce your risk including choosing the most trusted implant type and placement (under the chest muscles vs. over the chest muscles), using an antibacterial wash during surgery, and placing the implants through a Keller funnel to limit contact between the implant and any potential pathogens before they go inside the body.
Dr. Aboutanos prioritizes patient safety and takes every step to minimize complications before, during, and after surgery.
About female plastic surgeon Dr. Sharline Aboutanos
Dr. Sharline Aboutanos is a board-certified plastic surgeon and highly sought-after cosmetic and reconstructive breast surgeon in Richmond, VA. If you’re concerned about capsular contracture or considering breast surgery, schedule a consultation with Dr. Aboutanos today. Call 804-355-3410 or contact her online for a personalized experience from beginning to end.
References
Denney BD, Cohn AB, Bosworth JW, Kumbla PA. Revision Breast Augmentation. Seminars in Plastic Surgery. 2021 May;35(2):98-109. doi: 10.1055/s-0041-1727272. Epub 2021 Jun 8.
Sood A, Xue EY, Sangiovanni C, Therattil PJ, Lee ES. Breast Massage, Implant Displacement, and Prevention of Capsular Contracture After Breast Augmentation With Implants: A Review of the Literature. Eplasty. 2017 Dec 21;17:e41.