Capsular Contracture occurs when the Breast Implant’s pocket is too tight. When a Breast Implant is placed, the body forms a pocket to hold the implant in place. Without this pocket, the Breast Implants would not stay in a predictable position. When the pocket becomes too tight, it can move the breast implant or make the breast feel firm. Breast Augmentation Revision is used when capsular contracture causes visible changes in the Breast Augmentation.
Breast Augmentation Revision – Capsular Contracture Before and After Pictures
Breast Augmentation Revision: Left – before shows capsular contracture and superior malposition; Right – after capsulotomy/capsulectomy the right Breast Implant is lowered to a better position.
Breast Augmentation Revision for Capsular Contracture
The Breast Augmentation Revision before and after pictures above show an example of the correction of capsular contracture. The picture on the left shows Grade III capsular contracture. As the capsule contracts, it squeezes the Breast Implant causing an apparent reduction in size of the breast implant. In this case, the lower pole of the breast implant is being squeezed more than the upper pole. The result is superior Breast Implant Malposition.
Correction of Capsular Contracture
Capsular Contracture is treated with either release of the capsule (capsulotomy) or removal of the capsule (capsulectomy). A Capsulotomy allows the capsule to expand, resulting in a softer breast augmentation. A capsulotomy can also be performed selectively in cases of malposition, to move the breast implant back into the proper position. Capsulotomy works best for thin, tight capsules.
A Capsulectomy is used when the capsule is thick. By completely removing the pocket around the implant, a new pocket is allowed to form. The Breast Implants may also be changed to help prevent recurrence. Capsulectomy is also used for breast implant removal when a silicone breast implant leaks. This allows for removal of all the contained silicone gel.
Breast Augmentation Revision Results
In the before and after pictures above, the right side shows the results. The right breast implant was lowered and is much softer. The upper pole of the breasts are now even, which increases the number of necklines that can be worn. The nipples and inframammary folds are also even, improving the appearance out of clothing too.
Breast Augmentation Revision Consultation
If you are considering breast augmentation revision, call (925) 943-6353 to schedule your personal consultation appointment.
In trying to answer some of the most frequently asked questions about Breast Augmentation Revision, I have provided information here and on my main web sites. Information on the Internet, however, cannot replace a consultation with a Board Certified Plastic Surgeon. If you are having problems with your Breast Implants, seek the advice of a qualified professional, preferably a member of the American Society for Aesthetic Plastic Surgery.
What Are the Most Common Reasons for Breast Augmentation Revision?
The most common reasons for Breast Augmentation Revision include:
The desire to Change Size
Breast Implant Deflation
Capsular Contracture
Breast Implant Malposition (often caused by capsular contracture)
Changing Breast Implant Size
One of the most common reasons for Breast Augmentation Revision is to change the size of the Breast Implants. The overwhelming majority of the time, the goal is to increase the size of the Breast Implants. The procedure is usually simpler, and has a much easier recovery, than the initial Breast Augmentation. The pocket is opened, the old implants removed, the pocket is enlarged (capsulotomy or capsulectomy), and new implants are placed. When the goal is to decrease the size of the Breast Implants, the procedure is the same except the pocket is not enlarged, and sometimes it needs to me tightened (capsulorrhaphy). Breast Implants can also be changed from Saline to Silicone Gel, and less frequently from Silicone Gel to Saline.
Breast Implant Deflation
Breast Implant Deflation and Replacement: Problem – Patient’s left saline breast implant has deflated. Solution – Patient desired larger breast implants so both sides were replaced with larger breast implants.
With the advent of improved manufacturing and materials, the risk of breast implant deflation is reduced. What happens when a breast implant deflates depends on what is it filled with. Saline Breast Implants go flat, and the solution is safely absorbed by the body. Silicone Breast Implants have a firm center, and initially there may be no sign of a leak. Over time, the gel can leak out of the capsule, and you may feel a lump. Any lump in the breast should be promptly investigated. The sooner a broken implant is replaced, the simpler the procedure will be. The big three US breast implant manufacturers all have warranties: Allergan, Mentor and Sientra.
Capsular Contracture
Capsular Contracture Before and After Capsulectomy: Problem – Capsular Contracture leads to firmer, smaller and more centralized breast implants. Solution – Capsulectomy removes the tight scar, softening and expanding the implants.
Capsular Contracture is the term for hardening of the Breast Implants. The breast implants themselves do not get hard, but the scar capsule that lines the pocket in which the Breast Implant sits tightens. The scar squeezes the Breast Implants and can change the firmness, shape and position of the Breast Augmentation. In the before picture above the redness of the breasts is caused by congestion of the circulation. It the most severe cases of Capsular Contracture (Grade IV) not only is the shape of the breast changed, but the breast also become painful.
Treatment of Capsular Contracture includes one, or a combination of:
Capsulectomy (removing the scar)
Capsulotomy (opening the scar)
Breast Implant Replacement
Breast Implant Malposition
Breast Implant Malposition is a large topic by itself. When Breast Implant Malposition is caused by Capsular Contracture, the treatment is similar to that described above. When caused by Breast Implants that are too large for a woman’s frame, reducing the size of the Breast Implants may be an important part of the treatment. When implants are too low, the inframammary fold may need to be repaired, or completely reconstructed as is often the case in Breast Reconstruction after a mastectomy. Symmastia is also a form of Breast Implant Malposition that is seen when the breast implants migrate towards each other, breadloafing and forming a uniboob.
Problems With Breast Augmentation
If you have problems with your breast augmentation, seek the assistance of a Board Certified Plastic Surgeon, who has experience with the correction of Breast Augmentation. Although many of the skills required for Breast Augmentation are necessary for Breast Augmentation Revision, Breast Augmentation Revision Specialists have developed specific skills, and can help guide you to achieve safer and more predictable results.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies continue to change as we age. Breasts naturally change size and shape over time. This occurs with or without breast augmentation. While most changes are gradual, changes can happen relatively quickly with pregnancy and changes in weight.
Breast Implant Replacement
Breast implants can wear out too, requiring a new implant to be placed. The major US breast implant companies, Allegan and Mentor, do provide Breast Implant Warranties.
What Are the Common Reasons for Breast Augmentation Revision Surgery?
The most common reasons for Breast Implant Revision Surgery are a desire for a change in size, deflation of the breast implant, capsular contracture and breast implant malposition. It is important to clearly identify what problem(s) are bothersome, and to seek a consultation with a Board Certified Plastic Surgeon.
Below is number four of four of my latest Breast Implant Revision Videos. They appeared on KRON4′s Body Beautiful. The series covers Breast Augmentation, Breast Implants and Breast Augmentation Maintenance. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation and Breast Implant Revision Surgery video includes:
The type of trauma most likely to cause breast implant deflation
Common reasons for breast implant revision surgery
Changing breast implant size
Breast implant leaks
Capsular Contracture
Breast Implant Malposition
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
Breast Augmentation remains one of the procedures that I perform most frequently. Whether you’ve always had small breast and want them larger, or you had larger breast and want them back, Breast Augmentation can help you achieve your goals.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies change as we age. Breasts naturally change size and shape over time, and this happens even after breast augmentation. Changes can certainly be exacerbate by pregnancy and changes in weight, but most of the time the changes are gradual and sneak-up on us.
What’s New in Breast Implants and Breast Augmentation?
If you are considering Breast Augmentation or Breast Implant Revision surgery, you should know that new breast implants are available and more are on the horizon. New techniques are also being developed to help make your Breast Enhancement simpler, safer, more predictable and easier overall. Be certain to seek a Board Certified Plastic Surgeon for all your Cosmetic Breast Surgery needs.
Below is part three of four of my Breast Implant Revision Video that appeared on KRON4′s Body Beautiful. Options in Breast Augmentation, Breast Implants and Breast Augmentation Maintenance are reviewed. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation, Breast Implant Revision Surgery video includes:
The Breast Implants currently available
Saline Breast Implants – Natrelle (Allergan) and Mentor (J&J)
Silicone Gel Breast Implants (Natrelle and Memory-Gel)
Soft-Solid Silicone Breast Implants (GummiBear Implants)
Natrelle 410′s*
Mentor Contour Profile Gel (CPG)*
*The 3 yr and 5 yr data for the 410′s and CPG breast implants surpasses that of the breast implants that are already approved in this country. Why are they not approved? Only your FDA knows for sure.
Breast implant deflation
What are the signs and symptoms associated with a leaking breast implant?
How to check for a breast implant leak
How long do Breast implants last?
How are breast augmentation and breast lifts combined?
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. Breast Augmentation Revision can help with Breast Implants are the wrong size, in the wrong position, have developed capsular contracture or when other cosmetic deformities require correction. Specific techniques have evolved for the correction of the most common problems that can occur with Breast Implants. Some recently developed new techniques have significantly improved the results of breast implant revision for problems that have been difficult in the recent past.
San Francisco Bay Area Breast Augmentation
This segment of Body Beautiful focuses on before and after results. Breast Augmentation is reviewed, as well as the correction of specific breast implant problems like capsular contracture and implant malposition (bottoming out and symmastia). The following Breast Implant Revision Video was broadcast on KRON4′s live Medical Monday show, Body Beautiful. The television show allows viewers to call in during the broadcast and have their questions answered. The (415) number shown in the video was only for the show, so if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353, or use the contact form on the left.
San Francisco Bay Area Breast Augmentation & Breast Implant Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation, Breast Augmentation Revision Surgery video includes:
Before and After Pictures of Breast Augmentation
Before and After Pictures of Breast Augmentation Revision including:
Before and After Pictures of Breast Augmentation Revision for a Breast Implant that is too low and a poorly formed inframammary fold (IMF)
Before and After Pictures of Breast Augmentation Revision for Grade III Capsular Contracture causing the Breast Implant to be too high (Capsulotomy/Capsulectomy)
Before and After Pictures of Breast Augmentation Revision for Grade IV Capsular Contracture causing the implant to ride up and appear significantly smaller
Before and After Pictures of Breast Augmentation Revision for Breast Implants that are too close (as seen in symmastia) and too far from the midline (often causing a large gap between the breast implants) and rippling on the inside of the breast (medial rippling)
Before and After Pictures of Breast Augmentation Revision for severe bottoming out with internal capsulorrhaphy (though a breast lift is the most frequently selected option)
Breast Augmentation and Breast Implants Revision Resources
You are viewing part two of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the additional segments:
Breast Augmentation remains one of the most popular cosmetic plastic surgery procedures. While often the procedure lasts a lifetime, breast augmentation revision is quite common. Breast Implant Revision has emerged as a specialty unto itself. While many of the tenants that lead to excellent Breast Augmentation results will also apply to Breast Augmentation Revision, new and specific techniques have evolved for the correction of the common problems that can occur with Breast Implants.
The most frequent reasons for Breast Augmentation Revision Surgery include the desire to change the size of the breast, breast implant deflation, problems with the position of the breast implants and tightening of the scar that normally forms around the breast. The last listed is called capsular contracture.
San Francisco Bay Area Breast Augmentation
What follows is a Breast Implant Revision Video segment from KRON4′s live Medical Monday show, Body Beautiful. The television broadcast allows viewers to call in and have their questions answered live. The (415) number shown in the video was only for the show, so if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353, or use the contact form on the left.
San Francisco Bay Area Breast Augmentation & Breast Implant Revision Video
San Francisco Bay Area Breast Implant Questions
This Breast Augmentation, Breast Augmentation Revision Surgery video includes:
What to consider before having Breast Augmentation
Is “routine maintenance” for Breast Implants required?
If my Breast Implants are too high, can they be lowered?
If my Breast Implants are too low, can they be raised?
If my Breast Implants are too wide, can they be moved towards the middle?
If my Breast Implants are too close together, can they be separated?
What causes Breast Implants to fail?
Can I maintain my body proportions and have Breast Augmentation?
What are the problems associated with Breast Implants which are too big?
Breast Augmentation and Breast Implants Revision Resources
You are viewing one of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the additional segments:
Breast Augmentation and Breast Implant Revision San Francisco Bay Area – 1 of 4 (You Are Here)
Capsular Contracture occurs when the scar that normally forms around a breast implant becomes too much scar. It is normal and desirable that a scar forms around the breast implant. The scar forms a pocket called the capsule. The capsule secures the breast implant and keeps it from migrating around under the skin. The capsule is very important to prevent malposition and bottoming-out of the breast implants. A normal capsule is soft and cannot usually be felt.
What is Capsular Contracture?
Capsular Contracture occurs when the capsule is too tight or too thick. While Wikipedia defines capsular contracture as an abnormal response of the immune system, it is more likely an exaggerated normal response. If the capsule is tight all around the breast implant, it can make the breasts feel hard and immobile. If the capsule is tight on just one side, it can push the implant. For example, when the scar is tight on the bottom, it moves the implant up. The result is the opposite of bottoming out.
Baker’s Grades of Capsular Contracture
Capsular Contracture is graded (Baker grades) as follows:
Grade I – Naturally soft. Not palpable
Grade II – Increased firmness. Scar is palpable. No visual distortion.
Grade III – Firm to touch. Immobile causing visual distortion.
Grade IV – Same as Grade III and painful.
Grades I and II are the most frequently seen capsular contractures and are not normally treated. Grades III and IV are less frequent, and are often treated with a Breast Augmentation Revision Surgery.
Capsular Contracture Treatment
Many non-operative treatments exist and none have been proven to be clinically effective. Massage, ultrasound, vitamin-E, antibiotics, steroids and the latest leukotriene inhibitors (Accolate) have been tried with occasional anecdotal improvement, but there are no large studies proving any of these techniques safe and effective for treating capsular contracture. They are frequently employed with grade II and early grade III capsular contracture in an attempt to reverse the progression to a tighter scar capsule.
The best method of treatment remains breast implant revision surgery. For grade III and IV capsular contractures, capsulotomy and capsulectomy are the mainstay of treatment. Capsulotomy is a surgical technique during which the capsule is incised to allow for expansion. This is most effective when the scar is thin and soft. Capsulectomy is the surgical removal of the scar. This is used when the scar is thick. There is a slightly greater risk of bleeding with the capsulectomy.
More Information about Capsular Contracture is Available Here
Additional articles about Capsular Contracture are available here on the San Francisco Plastic Surgery Blog. Just click these links:
Breast implants are used to increase the size of the breasts. If you are happy with the shape of your breasts, but desire increased volume, breast augmentation with a breast implant may be a good choice. Cosmetic breast enhancement includes other breast procedures also. For overly large breasts, breast reduction is an option. For deflated breasts, breast augmentation and breast lifts are the preferred treatments. Many of these options are outlined in detail on the San Francisco Breast site.
Last month, on KRON4′s Body Beautiful, I had the opportunity to discuss cosmetic surgery of the breast. Below is an excerpt from my interview with the Bay Area’s News Station’s Vicki Liviakis. This segment includes more caller questions. Please note, the 800 number in the video was used exclusively as part of the live show. If you have questions, or would like to schedule a consultation appointment, please call my office directly at (925) 943-6353, or use the contact form on the left side of this page.
This breast augmentation video includes answers to viewers questions about:
Breast implant revision surgery
Capsular contracture
Breast implant complications
Silicone breast implant leaks and MRI
Breast reduction insurance coverage
Breast feeding after breast augmentation
Transgender breast augmentation
Gynecomastia and male breast reduction
Finding the Right Breast Augmentation Surgeon
If you are considering breast augmentation, be certain to review the benefits, and the risks, with a Board Certified Plastic Surgeon like myself, as part of your breast augmentation consultation appointment. If you have developed problems with your breast implants, a consultation with a Board Certified Plastic Surgeon is the best first step toward finding relief.
Additional Information on Cosmetic Breast Enhancement
If you were peaking ahead, the preview screen on the video shows a side-by-side comparison of before and after pictures for breast reduction (reduction mammoplasty). I perform many different aesthetic breast enhancement surgeries. Sometimes reducing the volume and lifting the breasts is the best course of action. For patients with large breast and symptoms like lower neck and upper back pain, shoulder rutting from the bra straps and even recurrent rashes beneath the breasts, breast reduction surgery can provide an improved quality of life. It goes beyond being able to find clothes (and bras) that fit, but my patients are happy about that too.
Breast Reduction, Breast Augmentation and Breast Implant Revision Before and After Pictures
The 800 number in the video was used as part of the live show to allow viewers to have their questions answered by me, live, during the original broadcast. If you have questions, or would like to schedule a consultation appointment, please call (925) 943-6353, or use the contact form on the left side of this page.
Bay Area Breast Implants – Part 2 or 4
This cosmetic breast enhancement video includes information about:
Cosmetic breast enhancement including before and after pictures
I cannot emphasize this enough. If you are considering breast augmentation, be certain to review the benefits, and the risks, with a qualified Board Certified Plastic Surgeon, like myself. This is an important part of any breast augmentation consultation appointment. This is equally important if you have developed problems with your breast implants. A consultation with a Board Certified Plastic Surgeon is the best first step toward finding relief.
Additional Information on Cosmetic Breast Enhancement
Dr. Joseph Mele appears on KRON4's Body Beautiful.
To celebrate the debut of the new San Francisco Breast dot com (SanFranciscoBreast.com), a site dedicated to cosmetic breast surgery for the San Francisco Bay Area, I will be dedicating my appearance on Monday’s Body Beautiful on KRON4 to the breast. Breast augmentation, breast lifts, breast reductions, breast implant revisions, everything related to enhancing the breasts is open for discussion.
Body Beautiful is broadcast live at 11:00 AM on KRON4, so tune in and phone in with your breast questions. Whether you have had breast surgery, or are considering it, the show will cover a variety of topics. For a preview of what’s in store visit SanFranciscoBreast.com.
What’s new in Breast Enhancement Surgery?
The new web site is a comprehensive and authoritative review of the latest techniques in aesthetic breast surgery. Located in the San Francisco East Bay Area city of Walnut Creek, Plastic Surgeon, Joseph Mele, has lent his years of experience, and breast expertise, to this free patient education resource. The site is illustrated with graphics, videos and before and after pictures, and there is more to come. The list of topics covered is long and includes:
I look forward to hearing from you on Monday. If you will not be able to watch KRON4 at 11 AM on Monday, December 13, 2010, and you have a question you want answered, you can send your question via the contact form to the left. I will send you a personal response, and perhaps your question will be answered live during Body Beautiful.
