Stage 1 Symptoms and Signs:
Grade I capsular contracture is essentially a normally soft breast implant. There are no signs of any breast implant hardening. The breast implant can move comfortably inside the breast implant pocket. Breasts are not painful and not tender to touch. Visible or palpable ripping of the breast implant shell may be present, but they are not an indication of breast implant scar capsular contracture.
What you do: Excellent communication with your plastic and reconstructive surgeon is paramount before your breast augmentation surgery. Patients must select the appropriate size, style, and shape of implant which most suits their figure and needs. Excessively large implants increase the chance of capsular contracture. Placing the implants under the pectoralis muscle decreases the chance of capsular contracture. Textured breast implants have also been shown to decrease the risk of capsular contracture. Consultation with a plastic and reconstructive surgeon certified by the American Board of Plastic Surgery is the first step in assuring the best outcomes. Patients must discuss their ideal breast size and look as well as implant type and location in order to optimize their outcome.
Prevention of breast implant capsular contracture is the most important task after breast augmentation surgery. Patients should regularly massage breast implants as breast massage has been shown to decrease the incidence of breast implant capsular contracture. If patients notice development of any change such as slight firmness at one or both breast implants, patients should contact a plastic and reconstructive surgeon as soon as possible for an appointment. Close follow-up appointments with a plastic surgeon are important to treat timely and even prevent post-operative complications. So be sure to return for all of your follow-up appointments!
Prophylactic antibiotics are indicated for any dental procedures or tooth cleaning within six months of breast augmentation surgery. Bacteria can travel via bloodstream to the breast implant causing an inflammatory reaction which can be the beginning of capsular contracture.
What your surgeon does:
Prevention of capsular contracture begins even prior to your breast augmentation surgery. Your plastic and reconstructive surgeon must discuss your ideal implant size, shape, material, location, and incision before breast augmentation surgery. Breast augmentation methods which reduce capsular contracture include placement of the breast implant under the pectoralis muscle (versus over the muscle), using textured implants (versus smooth implants), limiting handling of the implants and minimizing skin contact prior to breast implant insertion, and irrigation of the implant pocket with antibiotic solutions.
Following patients' breast augmentation surgery, regular follow-ups by plastic and reconstructive surgeons are paramount in minimizing complications. To stop a problem at its early stages is of utmost importance. Examination on the day after breast augmentation surgery is recommended. Another examination one week after surgery, followed closely by another follow-up three weeks after your surgery are also important. These early visits serve to minimize the risks of early complications from breast augmentation surgery. Capsular contracture may begin anytime after breast augmentation: from a couple of weeks to decades after breast augmentation. The intervals between plastic surgery office visits essentially double until patients reach the one year after surgery visit. The late follow-up appointments are to diagnose late complications after breast augmentation surgery. After the first post-operative year, patients should continue annual breast examinations by a plastic and reconstructive surgeon to evaluate patients' breasts for any masses, implant rupture, or capsular contracture. If patients are over forty, an annual mammogram is currently recommended to evaluate for breast cancer.
Insurance coverage: If patients wish to have breast implants removed or exchanged, and they have normal breasts with a stage one capsular contracture, patients' insurance company will not likely cover the expenses of patients' surgery. However, some insurance companies do cover the elective removal of normal breast implants . Insurance companies will never pay to have breast implants replaced. A patient's plastic and reconstructive surgeon can write a letter addressed to the patient's insurance company to request pre-authorization for implant removal surgery. Pre-authorization will improve the chances of insurance companies paying for implant removal surgery.
Timeline: Breast implant capsular contracture may occur anytime after breast augmentation surgery. Prevention of capsular contracture or tight scar formation around breast implants is the main goal in Grade I. Breast massage should begin by the second week after surgery once any pain has minimized. Regular breast massage, annual physical examination by a plastic and reconstructive surgeon, and mammograms after the age of forty are all imperative to excellent breast health.
