To put it simply, capsular contracture occurs when scar tissue forms, causing the breast implant to feel hard and appear distorted. It is a known risk that comes with breast augmentation surgery. While there is no way to prevent it from occurring, there are ways to reduce your risk. There are also treatments in place that can help, should the problem arise.
Closed Capsulotomy (non-surgical)
In this non-surgical procedure, the surgeon forcibly squeezes the implant, in hopes of "popping" the scar tissue (opening it up). Breast implant manufacturers do not recommend this, as it can lead to possible rupture of the implant. Implants that are ruptured due to closed capsulotomy are not covered under the warranty (this includes Mentor and Allergan). You are awake for this, and receive no local anesthesia. And yes, it can be painful, but thankfully, it only lasts a few seconds, and then it's over.
This procedure is usually not recommended, since it has a very low success rate, and again, puts you at risk for breast implant rupture.
Open Capsulotomy (surgical)
In this procedure, the surgeon goes into the pocket and "scores", or cuts, the scar tissue, in order to release the capsule's hold on the implant. The scar tissue is not removed. Depending on the surgeon and his skill/experience, it's possible to do this procedure via the transaxillary incision, as well as via the crease and areola incisions. You will be given a local anesthetic with IV sedation, or general anesthesia for?this particular procedure.
Open Capsulectomy (surgical)
This is the most successful treatment for capsule contracture. In this procedure, the surgeon goes in and actually removes the scar capsule. This is a lengthier surgery, but is well worth it, especially when it's successful. Once the capsule is removed, your body will form a new capsule around the breast implant.
Medicines, Vitamins, and Supplements for Capsular Contracture Treatment
Some surgeons believe that Papaverine (also known as Papacon, Para-Time S. R., Pavabid Plateau, Pavacot, and Pavagen) may help to stop the progression of capsular contracture. Pavabid is in a class of drugs called vasodilators. It relaxes veins and arteries, which makes?them wider and allows blood to pass through them more easily. Papaverine is also a smooth muscle relaxant. The target of Papaverine, when used to treat capsule contracture, is the smooth muscle-like fibers in contractile scars. The flip side is that some doctors do not believe that it helps at all. There is no evidence that this drug will stop and/or reverse the effects of capsule contracture.
Scar tissue consists of collagen strands. Taking vitamin E is thought to soften these strands, thus making the capsule softer and more pliable. Unfortunately, there is no evidence that vitamin E really works in treating or preventing capsular contracture.
Some plastic surgeons use antibiotics to treat capsular contracture, though this isn't always successful. In the event that a person has capsular contracture, and the breast begins to swell, and/or become sore or painful, antibiotics may help. However, simply giving someone antibiotics in hopes of reversing a well-formed capsule isn't likely to be successful.
Accolate (asthma medication)
Accolate, a drug used in the treatment of Asthma, is the newest treatment for capsule contracture. It is used due to it's anti-inflammatory properties. It is a leukotriene receptor inhibitor. Leukotrienes are a group of chemical compounds that occur naturally in white blood cells (also known as leukocytes). They're able to produce allergic and inflammatory reactions. This drug inhibits this process. Accolate is said to work best on early contractures, but may reverse existing capsules. If the capsule is well-formed, it can take several months to successfully treat it. Prophylactic treatment may be used in women who are at a higher risk for capsule contracture, such as those who have had it previously.
Clinical studies still need to be done regarding the use of Accolate as a form of treatment for capsule contracture, although it does seem to have helped many women.
Using Accolate or other asthma medications to treat capsule contracture is "off-label" use, as these drugs haven't been approved by the FDA for treatment of capsular contracture.
External ultrasound, according to some doctors, helps capsule contracture. It may possibly reduce swelling, help to regulate inflammation, and facilitate healing, thus reducing the risk of recurrence. Ultrasound is usually accepted by patients, as it is easy to perform, and free of any major complications. Prophylactic ultrasound treatment may be used as well.