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Capsular Contracture Revision.

Capsular contracture is the most common reason of revision breast surgery. Tissue around the implant gets firmer as a reaction of the immune system to foreign material.

There are 4 grade of Capsular contracture by the Baker classification system.(1)

Grade I         The breast is normally soft and appears natural in size and shape.
Grade II        The breast is a little firm but appears normal.
Grade III       The breast is firm but appears abnormal.
Grade IV       The breast is hard, painful to touch and appears abnormal.
Grade III-IV needs revision surgery


Why is a capsular contracture happen?

The most common causes of a capsular contracture come from

1. Surgeon technique such as the  contamination , hematoma
2. Implant material; quality of the implant is variation, depending on material and makers
3. Patients,  the immune system and reaction to foreign material in each patient


How to correct it ?

1. Capsulotomy , the surgeon will expand the capsule .This technique is available for Grade 1-2
2. Capsulectomy , the surgeon will  removes the capsule that has been covered the implant for Grade 3-4


Incident of recurrence rate of after capsulectomyand placement of new implant is 30.7% reported by Caffee(2)



1. https://en.wikipedia.org/wiki/Capsular_contracture
2. https://journals.lww.com/prsgo/FullText/2016/10000/Open_Capsulotomy___An_Effective_but_Overlooked.7.aspx


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