Capsular contracture is manifested by a bad complication from breast augmentation or surgery. Capsular contracture treatment is hard and recurrences take place. The cause of the disease is under study but poorly comprehended. One assumption is that the condition results from low grade infections. It does not respond well with antibiotic therapy. One assumptions is that bleeding within the implant pockets during surgery or subsequent traumas cause inflammation and lead to the contracture.
Studies of the Probable Causes of Capsular Contracture
New studies suggest that biofilms can cause capsular contracture in various, if not all, of the contracture cases. A biofilm is manifested by a colony of some bacterial types which cover themselves within a protective coat. Foreign materials like orthopedic hardware and breast implants can develop biofilm coverage. Such lie dormant inside the host but cause occasional trouble. They are safeguarded by the host’s immune system by protective coating and chemicals.
Characteristics of Capsular Contracture
This explains some of the characteristics of the condition. First of all, a full capsulectomy will be more successful than just releasing a capsule. Secondly, the rate of recurrences is high should the same implants be replaced right after treatment of contracture. Thirdly, the condition often shows years or months after breast augmentation whereas the usual infectious procedures usually show themselves up a few days following surgery.
Two Major Phenomena Linked to Capsular Contracture
Two phenomena linked to capsular contracture don’t lead to biofilm. But risks for the disease have been reduced when implants were placed over the muscle. And an increased risk for capsular contracture has been observed to increase when used with silicone implants.
Structure of Biofilms
Biofilms are complicated structures. Cells within the biofilm contact each other to deliver signals to the colony for growth and cell death. These signals are for the good of the entire unit itself. Interference within these intercellular paths for communication can provide a treatment option in the future.
Preventing Capsular Contracture
Preventing capsular contracture must be a major priority to prevent contamination and stop the accumulation of biofilms. The glands over the nipple get a number of bacteria and circumareolar incisions have been discovered to have bigger risks in contracture. Preoperative antibiotics, bathing implants within antibiotics before placement, limiting touch before implant or placement, and postoperative antibiotics contribute in lowering the risks of capsular contracture.
Massaging of implants has been assumed to have decreased the risks of having capsular contracture. There’s less evidence which shows that is preventive. Majority of the plastic surgeons though recommends it. Accolate and Vitamin E are medicines that were used for both treatment and prevention for capsular contracture. There have been subtle evidences that lead to the latter.
Other treatments for Capsular Contracture include:
- Closed Capsulotomy
- Open Capsulotomy
Closed Capsulotomy: non-surgical – This is a non-surgical procedure where the surgeon squeezes the implant hoping to open a scar tissue. Breast implant suppliers don’t really recommend this since it can rupture the implant. Ruptured implants caused by capsulotomy aren’t covered under warranty and that includes Allergan and Mentor. You will be awake in this procedure and get no local anesthesia. This is a painful but fast procedure lasting only a few seconds.
Another reason why the treatment is not recommended is because of its low success rate and risk for breast implant rupture. It does not discredit surgery though as one of the most effective treatments for the condition.
Open Capsulotomy: surgical – This is a procedure wherein the surgeon goes inside the pocket and cuts or scores the scar tissue to release the hold over the implant. The scar tissue will not be removed. And depending on the surgeon’s skills and experience, it’s quite possible that the procedure can be done through transaxillary incision and through the areola and cease incisions. You will be administered with a local anesthetic along with IV sedation or general anesthesia in this specific procedure.
This is among the most successful treatments in capsule contracture. In this process, the surgeon will go in and remove the scar capsule. The surgery can be long but it will be successful. After the capsule is removed a new capsule will form surrounding the breast implant.
Vitamins, Medicines, and Supplements for Capsular Contracture Treatment
Pavabid. Some surgeons think that Papaverine or Papacon, Pavabid Plateau, Para-Time S.R. Pavagen and Pavacot may assist in stopping the progression of capsular contracture. Pavabid belongs to a class of drugs called vasodilators. Vasodilators relax the arteries and veins and make them wider to allow blood to easily pass through. Papaverine is a smooth muscle relaxant.
Papaverine’s target, used to treat capsule contracture, is the smooth muscle-like fibers within contractile scars. On the other hand, a number of doctors don’t think that this helps. There’s no evidence that the drug stops or reverses the effects caused by capsule contracture.