Introduction
Breast prosthesis capsular contracture is a common complication after breast augmentation surgery. It can cause discomfort, pain, and changes in breast appearance. In New York City, there are several hospitals and medical professionals renowned for their expertise in breast prosthesis capsular contracture repair. In this article, we will reveal the top 3 hospitals for this specialized treatment and also provide comprehensive information about capsular contracture, including its causes, symptoms, prevention, and treatment methods.
Understanding Breast Prosthesis Capsular Contracture
What is Capsular Contracture?
When breast implants are inserted, the body's natural response is to form a protective capsule of scar tissue around the implant. This is a normal part of the healing process. However, in some cases, the scar tissue can thicken and tighten beyond the normal response, leading to a complication known as capsular contracture. This abnormal reaction is often triggered by inflammation during the healing process, which can be exacerbated by factors such as bacterial contamination or excessive bleeding around the implant.
Symptoms of Capsular Contracture
- Hardening of the breast: The breast may feel firmer or even hard to the touch compared to the normal breast tissue.
- Breast pain: This can range from mild discomfort to severe pain, depending on the severity of the contracture.
- Tightness and firmness in the breast: Patients may notice a feeling of tightness or constriction in the breast area.
- Round or ball - shaped appearance: The breast may take on a more spherical or abnormal shape.
- Misshapen breast: There can be visible distortion or asymmetry in the breast.
- Elevation of the breasts: The affected breast may sit higher on the chest wall than normal.
Grades of Capsular Contracture
| Grade | Description |
|---|---|
| Grade 1 | The breast or breasts are soft and look natural. There are no visible or palpable signs of contracture. |
| Grade 2 | The breast or breasts are slightly firm but look normal and natural. There may be a slight change in texture that can be felt but is not visible externally. |
| Grade 3 | The breast or breasts are firm, look abnormal, and feel uncomfortable. The shape of the breast may be distorted, and there may be some pain or discomfort. |
| Grade 4 | The breast or breasts are hard, painful, and look abnormal. There may be significant distortion of the breast shape, including nipple irregularities. |
Grades 3 and 4 usually require surgical intervention, while milder cases may be managed with non - surgical treatments or monitored closely.
Causes of Capsular Contracture
The exact cause of capsular contracture is not fully understood, but several factors are believed to contribute to its development:
- Bacterial contamination: A thin layer of bacteria, called biofilm, can form inside the breast pocket. This bacteria can be introduced during the initial breast implant procedure or from other sources in the body, such as a teeth cleaning, colonoscopy, or an infected toe. Biofilm can cause an infection, which can lead to capsular contracture.
- Hematoma (blood accumulation) and seroma (fluid accumulation): These can provide nutrients for bacteria to feed on, increasing the chance of biofilm growth and capsular contracture. Drains may be used during surgery to help prevent blood and fluid accumulation.
- Incomplete breast cancer treatment: When breast implants are inserted after radiation treatments for breast cancer, the risk of capsular contracture may be increased.
- Genetic predisposition: Some individuals may be more prone to developing thick scar tissue due to their genetic makeup. A family history of autoimmune diseases may also increase the risk of capsular contracture.
- Random chance: In some cases, capsular contracture may occur without an identifiable cause, simply as a random event.
Top 3 Hospitals for Breast Prosthesis Capsular Contracture Repair in New York City
1. [Hospital Name 1 - Mount Sinai Hospital]
Mount Sinai Hospital is a well - known medical institution in New York City. Their breast implant revision specialists are highly skilled in medical care and plastic surgery. They have the expertise to correct problem areas related to breast implants, including capsular contracture. The plastic surgeons at Mount Sinai perform secondary or breast implant revision surgery by carefully matching and repairing the body's tissue with the breast implants to ensure that the position, shape, and texture of the breast implants are natural and beautiful. Before any procedure, patients will consult with a nationally recognized specialist who will discuss treatment options, which may include the use of new materials or meshes to stabilize the area around the breast implant and enhance the natural shape and texture of the breasts, such as fat transfer from other parts of the body.
2. [Hospital Name 2 - Vantage Plastic Surgery]
Vantage Plastic Surgery, led by the highly skilled double - board - certified plastic surgeon Dr. Aleksandr Shteynberg, offers advanced treatment for capsular contracture after breast implant procedures. Their clinics in Manhattan and Brooklyn provide comprehensive treatment options. For mild cases of capsular contracture, non - surgical treatments may be considered, although their success varies. In severe cases, surgery is often the most effective option. This typically involves the removal of the thickened capsule, and in some instances, partial or complete removal of the implant may be necessary. Depending on the circumstances, the implant may need replacement, or patients may opt for complete removal of both implants. The use of advanced surgical techniques at Vantage Plastic Surgery helps reduce the likelihood of capsular contracture recurrence in patients opting for implant replacement after a total capsulotomy.
3. [Hospital Name 3 - Antell Plastic Surgery]
Dr. Antell at Antell Plastic Surgery has extensive experience in treating capsular contracture. He uses a “np - touch technique” during surgery, which may contribute to a higher success rate and a lower incidence of capsular contracture compared to the published literature. If patients notice early signs of capsular contracture, Dr. Antell can examine them and suggest appropriate treatment approaches. For mild cases, he may be able to remove a portion of the scar tissue, which creates more space in the breast pocket and helps correct early capsular contracture. In more advanced cases, a capsulectomy is performed to remove the entire breast implant and the surrounding capsule at once, and new implants can be inserted based on the patient's aesthetic desires. The recovery process at Antell Plastic Surgery is carefully managed, with prescriptions for discomfort medication and clear instructions on post - operative care.
Treatment Options for Capsular Contracture
Non - Surgical Treatments
For mild cases of capsular contracture, non - surgical treatments may be attempted:
- Breast massage: Gentle massage of the breasts under the doctor's instructions can help keep the breast tissue pliable during the healing process and may prevent or reduce the severity of capsular contracture. However, its effectiveness varies from patient to patient.
- Medication: In some cases, leukotriene inhibitors such as Singulair and Accolate, paired with a low - dose antibiotic like doxycycline, may be prescribed to help soften the breast and treat early capsular contracture. Studies have shown some benefit in using these medications for prevention and treatment.
Surgical Treatments
- Removal of a portion of scar tissue: In mild cases caught early, it may be possible to remove a portion of the scar tissue. This procedure creates more space in the breast pocket and can correct early capsular contracture.
- Secondary breast augmentation with a capsulectomy: For more advanced cases, a capsulectomy is performed to remove the entire breast implant and the surrounding capsule at once. New implants can be inserted during this procedure based on the patient's aesthetic goals. In some cases, an en bloc removal (total capsulectomy) of the encapsulated implant may be recommended.
- Use of acellular dermal matrix (ADM): ADM, such as Alloderm or Strattice, can be used to line the implant cavity. This surgical approach has a high success rate (around 99%) in preventing capsular contracture recurrence. However, it requires surgery and careful consideration.
Recovery After Capsular Contracture Treatment
The recovery process after capsular contracture treatment depends on the type of treatment performed. For surgical procedures:
- Immediate post - operative care: Patients will need to arrange for a family member or friend to drive them home after the surgery and stay with them for the night. Pain and swelling are common after surgery, and doctors will prescribe medication to manage discomfort.
- Swelling and soreness: Swelling and soreness may last for several weeks. Wearing a surgical bra can help reduce swelling and support the breasts during this time.
- Return to normal activities: Most patients can return to desk - type work within a few days, but it may take a few months for the breasts to fully heal and settle into their new position. Heavy lifting and strenuous exercise should be avoided for 2 - 3 weeks or as advised by the doctor.
Prevention of Capsular Contracture
While capsular contracture cannot be completely prevented, the following measures may help reduce the risk:
- Implant selection: There is some debate in the literature about whether saline or silicone implants, and smooth or textured implants, have a higher rate of capsular contracture. However, smooth - textured implants may have a lower chance in some cases, and some studies suggest that submuscular placement of implants (under the pectoral muscles) is associated with a lower risk compared to subglandular placement (over the muscles) because the muscles can massage the implants and help keep the scar tissue soft.
- Surgical technique: Using a “no - touch technique” and a funnel to insert the implants can reduce the risk of surface contamination. Meticulous surgical technique, minimizing bleeding during and after surgery, and using antimicrobial irrigation during surgery can also help reduce the risk.
- Post - operative care: Following the doctor's instructions for post - operative activity restrictions and breast massage can be important. Minimizing early postoperative activity and waiting until the capsule has properly healed before resuming vigorous exercise can help prevent small tears in the healing capsule that may lead to capsular contracture.
Conclusion
Breast prosthesis capsular contracture is a significant concern for patients who have undergone breast augmentation surgery. However, with the availability of specialized treatment options in New York City, patients can find effective solutions to address this complication. The top 3 hospitals mentioned - Mount Sinai Hospital, Vantage Plastic Surgery, and Antell Plastic Surgery - offer a range of expertise and advanced techniques to repair capsular contracture and improve the appearance and comfort of the breasts. By understanding the causes, symptoms, treatment options, and prevention methods of capsular contracture, patients can make informed decisions about their breast health. If you are experiencing symptoms of capsular contracture or have concerns about your breast implants, we encourage you to schedule a consultation with one of these top - rated hospitals to explore your treatment options and regain your confidence and well - being.
