Breast Implant Correction, Revision, Replacement

(Dr. Bennett Yang, MD, FACS, PC. , a Board Certified Plastic Surgeon specializing in breast augmentation, tummy tuck, hair transplant, liposuction and brazilian butt lift. Please visit any of our 3 plastic surgery practices in Rockville Maryland, Annapolis and Mclean, Tyson’s Corner, Virginia.)

What is a capsular contracture?

Capsular contracture is the term used to describe a hard firm breasts after breast augmentation surgery. This is caused by thick firm scar tissue that forms around the implant. Capsular contracture is an unpredictable complication. This is the most common complication following breast augmentation. It can form on either one breast or both. It is more common when the periareolar incision is used.

The examination of each breast is classified on the Baker scale of I to IV:

  • Grade I: The breast is soft and normal
  • Grade II: The breast is less soft than normal, and the implant can be palpated
  • Grade III: The breast is firm, the implant can be palpated easily, and an asymmetrical distortion of shape can be appreciated
  • Grade IV: The breast is hard, tender, painful, and the shape distortion is pronounced or severe

Before

After

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Before

After

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What treatment methods are available for capsular contracture?

1. Zafirlukast (Accolate)
Zafirlukast (brand name: Accolate) taken twice a day for 90 days has been shown to result in a softening of the scar tissue around the implants in approximately 50% of cases. This medication is normally used to treat asthma, but is helpful in reducing the degree of capsule scar hardness. Risks: Allergic rashes.

2. Capsulectomy (complete removal of the scar capsule)
For those patients without significant softening during a trial of Accolate, the only other effective alternative is to completely remove the scar tissue surrounding the implant. Although this does not eliminate the possibility of future scar tissue forming around the implant, it does reduce the risk of subsequent capsular contracture when compared to other methods.

 

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