Capsular Contracture

When any foreign substance is introduced in the body, the body forms a ring around it. The foreign body may be a breast implant, a pacemaker or joint replacement etc. This ring is made of tightly woven collagen fibers and is formed as an immune response around a foreign body. A capsular contracture happens when the capsule tightens and squeezes the implant which can be painful and changes the appearance of the implanted breast or limits the range of the artificial joint. Capsular contracture may also happen after an additional surgery. Capsular contractures are the abnormal responses of the immune system to foreign materials in the body. A point to be noted is that capsule formation is normal but capsule contracture is not normal and can lead to problems. The capsule is a shield to the body from foreign objects and it may prevent friction within the body cavity.

To correct the situation, a surgical removal or release of the capsule or replacement of the implant is recommended. Sometimes the capsule can be disrupted by external manipulation but this can result in rupture of the implant and hence it is not advisable. Non-surgical methods like massage, treatment with medicines, external ultrasound or pulsed electromagnetic field therapy may also be applied. But if they don’t respond, then the best way is a surgical procedure.

Though capsular contracture happens around any foreign body, the most common kind is the breast capsular contracture. This type of contracture is graded at four levels- one when the breast is normally soft and looks natural, the second is when the breast is a bit firm but still looks normal, the third is when the breast is firm and looks abnormal and the fourth grade is when the breast is hard, painful and looks abnormal. Science has not yet found a definite reason why some patients have capsular contracture but others don’t. Sometimes hematoma, bacterial introduction through the milk ducts, or infections can cause capsular contractures.

If the breasts appear misshapen, deformed, painful or firmer than before, one may suspect that one might have developed capsular contractures and the doctor has to be consulted for treatment. Pocket exercises or movements as advised by the doctor can prevent it from forming. Massaging or taking Vitamin E orally can also help in preventing it. If massaging under medical advice is done after the implant then the chances of CC are less. However if a person does get capsular contractures, most surgeons will attempt squeezing to remove it, but such a procedure may result in rupturing the implant or may cause internal bleeding, hence this method is not advisable.

Surgery or removal of the implant and re introducing it at a later date may be the answer. Sometimes getting hit on the chest by a ball or some object or an impact in a collision with seat belts hitting the chest, may also result in CC.