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)