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Contracture after mammoplasty: reasons and what to do?

Contracture after mammoplasty: reasons and what to do? Plastic surgery helps to radically solve the problem of appearance, so they resort to it in cases where aesthetic procedures do not give the desired effect. Breast augmentation surgery is the first in popularity among women. Plastic surgery can cause complications, both general and specific. In 10% of women, a side effect such as contracture may occur. To get rid of such consequences, you need to contact the clinic.

What is contracture and its causes

Breast augmentation surgery involves the installation of implants in the area under the mammary glands. At the same time, the patient’s body reacts quite naturally to a foreign body around the prosthesis, connective tissue begins to accumulate, growing into its surface. This is a normal reaction in all operated patients. Normally, the thickness of this connective tissue around the implant should not exceed 1 mm.

Contracture is the formation of a capsule of dense connective tissue around the prosthesis, which presses and deforms it. This phenomenon may occur after implantation of any foreign bodies in any part of the body. In case of fibrosis, after mammoplasty, the breast loses its initial postoperative form, painful sensations appear. The thickness of the seal in this case reaches several millimeters.

Experienced surgeons cannot predict whether a particular patient will have such a reaction and complication, this is due to various reasons and always individually. The main danger of contracture due to compression of the prosthesis is the risk of rupture, which will entail serious consequences for the health and even life of the patient.

Fibrosis and capsule formation in the implant area are associated with the appearance of hematomas, injuries, infection or damage to the breast, both during mammoplasty and after it.

The causes of complications in the form of contracture with breast augmentation:

  • improper plastic surgery, that is, poor-quality work of a plastic surgeon, rough and inaccurate incisions, improper techniques, improperly installed drains, resulting in hematomas, injuries to muscles or mammary glands during the intervention, the subcutaneous layer exfoliates and serous fluid forms, which provokes the development of fibrosis tissues in this area;
  • improperly selected endoprosthesis in shape, size or quality, too large a prosthesis compared to a pocket prepared for it, which is why over time compression occurs and the capsule grows;
  • individual reaction of the body to the operation; deep scars, rejection of a foreign body are formed;
  • non-compliance with sterility during surgery, the appearance of inflammation inside;
  • improper rehabilitation after surgery, bad habits, trauma to the chest and the formation of bruises, taking certain medications;
  • endoprosthesis rupture and silicone leakage;
  • non-compliance with contraindications.

Today, mammoplastics use modern silicone implants with a raised surface. If the operation used outdated smooth endoprostheses, they provoke the development of fibrosis and the formation of compaction.

Symptoms of capsular contracture after mammoplasty

During the first year, breast deformity can be detected. It can occur on one side or on both breasts. In some cases, contracture appears later in a few years. At the first stage, the breast becomes denser to the touch, then its shape changes from deformed to unnatural spherical.

At different periods of detection of complications, one can distinguish the following degrees:

  1. Early appearance, you can detect signs in the first year after surgery in the process an infection appears inside the chest, connective tissue scars form.
  2. Late appearance, several years after surgery due to wear or rupture of the prosthesis, the flow of silicone into the cavity of the chest pocket and the appearance of inflammation.

Contracture after mammoplasty: reasons and what to do? Both cases are equally hazardous to the patient's health and require immediate intervention. If we consider both degrees in stages, we can distinguish the following stages of development of contracture:

  1. Soft breasts, endoprosthesis of the usual form, the capsule is thin and without compaction.
  2. You can feel the implant inside, its edges are felt, the structure of the breast is more dense than before.
  3. Sealing becomes more noticeable, the contours of the endoprosthesis are visually visible.
  4. Hard shell, pain on palpation occurs.

Symptoms of the pathology can be detected visually and during the examination of palpation, ultrasound or MRI. At the last stage, the breast is deformed, loses its original appearance, as after surgery, the presence of prostheses is even visually noticeable. There is no such side effect when carrying out an aesthetic breast lift when implants are not used.

Is contracture dangerous after breast augmentation

The contracture is manifested not only by tightening of the chest and painful sensations, but also by its deformation, which nullifies all the efforts of doctors to correct the figure. Visually and to the touch, clearly identifiable implants deprive self-confidence and mutilate a woman. In addition, the resulting capsule presses on the prosthesis and can provoke its rupture in the future.

The danger of capsular contracture is at risk of rupture of the endoprosthesis and silicone getting into the blood, infection of adjacent tissues. To prevent such consequences, as well as to correct a side effect, to return the previous shape of the breast, you need to consult a surgeon and fix the defect.

During the operation to correct the problem, anesthesia is used, and this is still a load on the body. To avoid such complications, one should adhere to the rules of rehabilitation and not go to unknown dubious clinics for breast augmentation.

Contracture Elimination Techniques

Fibrous densification can be eliminated without surgery, if you apply at an early stage of the manifestation of complications. At the first signs of an increase in breast density, you should contact the clinic, where physiotherapy will be prescribed to smooth out scars. At the initial stage, massage, taking vitamin E, a complex of anti-inflammatory injections will also help to stop the capsule compaction process.

If the patient asked for help at stages 3-4 of the pathology, an operation is performed. To choose the methodology for the operation, it is necessary to undergo a diagnosis of the condition to have an MRI or ultrasound scan, undergo tests, undergo an examination with palpation by the surgeon.

There are 3 methods of treating contracture that are used, depending on the condition and indications:

  1. An open capsulotomy with a skin incision is used to evaluate the thickness and location of the capsule (in front of or behind the implant), if the prosthesis is possibly shifted. The goal is to reduce the pressure of the capsule on the implant.
  2. Capsulotomy with the use of an endoscope, the incision is minimized, drainage, tissue cleaning is performed, as a result of which the compaction may decrease. In this case, small scars remain invisible after the operation. This technique does not allow removal or replacement of the implant.
  3. Capsulectomy can be complete or partial. Remove the capsule and prosthesis itself. To exclude further complications when replacing dentures with new ones, their location in the muscle layers is changed. This technique is the most traumatic of all and is used according to indications.

Contracture after mammoplasty: reasons and what to do? The choice of treatment method depends on many factors, both on the stage of development of the complication and on concomitant diseases, contraindications, individual reactions. If the patient has rejection of the prosthesis and antibiotic therapy does not help, it is removed. It will be possible to establish a new one only after rehabilitation, when the body will be completely healthy, and the doctor will establish the cause of this side effect.

Contracture Prevention Methods

To avoid the occurrence of such a complication as capsular contracture, it is worth initially contacting the clinic with a good reputation. Only a properly selected implant of the required size and shape, as well as the accurate and clean operation of the surgeon will reduce the likelihood of inflammation and fibrosis. If the operation was performed by a competent doctor using advanced technologies and in complete sterility, and the patient followed the rules of postoperative rehabilitation, the likelihood of such a side effect will be reduced to 0.2 2%.

In the FAQ section, you can read patient reviews and surgeons' advice for those who have already passed or are just planning to undergo a mammoplasty operation. We recommend that patients select prostheses of the appropriate size to avoid negative consequences.

You should adhere to the rules and measures that will help avoid the appearance of capsules and scars:

  1. Choose only modern structured endoprostheses with a raised surface. The relief does not allow the implant to move and form edema with friction. When the prosthesis grows into the tissue, a thin capsule is formed. When using a smooth prosthesis, the risk of fibrosis is several times higher.
  2. Only high-quality certified implants from well-known manufacturers are used; these are dentures of the 4th and 5th generation. Today, you can choose from not only silicone prostheses, but also with gel filling. A viscous cohesive gel will not flow as much as a silicone when a shell breaks.
  3. Before plastic surgery should be examined. A few months before the operation, any chest injuries and the appearance of hematomas and seals should be excluded. You can not do mammoplasty with mastopathy.
  4. During the rehabilitation period after surgery, adhere to the recommendations of the surgeon to avoid injury or infection of the mammary glands and the site of the operation.
  5. To prevent the prosthesis from sagging in the future, you need to wear only compression bras for the first few months.
  6. To enhance the flow of blood to the chest area, improve metabolism and avoid stagnation of fluids in the area of ​​prosthesis installation, the doctor may prescribe physiotherapy, exercises or massage. It is impossible to conduct it yourself without the appointment of a surgeon.
  7. Regularly make visits to your surgeon, conduct examinations, so that with the first symptom of the appearance of seals to solve the problem, not leading to surgery.

Plastic surgeons advise you not to delay a visit to the clinic at the first sign of chest tightening, even when there are no visible changes. Thin women with thin skin on their breasts are advised to use gel implants.

You should monitor the condition and change of the breast during pregnancy, after childbirth and during breastfeeding, as hormonal surges can also lead to contracture.

Material prepared by
specialists of the Clinic for Plastic Surgery
12-02-2020
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