Capsular contracture involves the hardening of the fibrous tissue that surrounds all breast implants after implanted in the body, for example during breast augmentation surgery or breast reconstruction. It is quite rare, and something most patients will never experience. It can occur in the tissue surrounding one or both implants. Capsular contracture varies in its severity, and the most severe type can be painful. Myofibroblast cells, which make up a component of the capsule, the same cells that cause wounds to contract as they heal, will also contract to varying degrees inside your body.

There are four grades of capsular contracture, known as Baker Grades:

Grade I: Breast is normally soft and looks natural

Grade II: Breast is a little firm but looks normal

Grade III: Breast is firm and looks abnormal

Grade IV: Breast is hard, painful, and looks abnormal

Grades III and IV capsular contracture are considered severe, and may require reoperation or implant removal. Capsular contracture, whether mild, moderate or severe, may occur more than once in the same implant.

The incidence of capsular contracture is quite low: between 4%, as estimated by Ideal Implants in their FDA Patient Labeling, and 8%, as estimated by Mentor in its FDA Patient Labeling, primary breast augmentation patients.

We aren’t sure why capsular contracture occurs, but there is some thought in the scientific community that it is correlated to bacterial contamination during the initial breast implant insertion. This postulated bacterium is normal skin flora and lives in the milk ducts. As a board-certified plastic surgeon, Dr. Zuckerman is very familiar with the latest protocols to minimize this risk. For example, during the procedure, Dr. Zuckerman irrigates the breast pocket where the implants will be placed three times with triple antibiotic solution. He then repreps and redrapes the entire sterile surgical field and changes his gloves prior to insertion of the implants. In addition, to place the breast implants, he uses an implant delivery device called a Keller funnel, which allows him to insert the implants without ever touching them.


<p>The actual term "Rapid Recovery Breast Augmentation" was originally coined by Dr. John Tebbetts of Dallas in 2002 and referred to a specific technique designed to limit bleeding intraoperatively but is mostly a marketing term. However, recovery after breast augmentation is limited by the body's ability to heal.  As such, recovery can only be so "rapid". However, my patients can have surgery on Friday and return to work Monday or Tuesday.</p>


<p>Stretch marks after pregnancy or from previous weight gain are a tough problem. While there are many homeopathic remedies, there is no topical treatment that has been shown to eliminate them. They don't occur in everyone and have a genetic component. While a tummy tuck is not meant specifically to address stretch marks on the abdomen, it most often will by eliminating the tissue itself in which the stretch marks are present. </p>


<p>The below is a quote from a patient of mine, which was given to a reporter for the New York Post article: <a target="_blank" href="">Forget mani-pedis — now moms and daughters bond over Botox</a>. She details her experience in coming to visit my office with her mother. These two are among my favorite non-surgical treatment visitors!</p>


<p>One of the most common questions I receive from prospective liposuction patients is if there is a pre-operative weight limit. One of the biggest misconceptions patients often hold about liposuction is that it is a weight loss tool. I have also been asked how many pounds a patient can expect to lose via liposuction more times than I can count! While it is true that you can expect to lose a few pounds and noticeable volume from an area after liposuction, the weight of the fat removed is not significant. The most significant effect is the change in contour and shape of the area targeted. </p>


<p>The breast lift, or mastopexy, and breast reduction are two of the least-discussed cosmetic surgery procedures, but they are two of the most important. My patients, and indeed patients in general, are overwhelmingly satisfied with their results. And, these two operations are among the fastest growing plastic surgery procedures, with the number of procedures performed up 70% in the period 2000-2014 according to the American Society of Plastic Surgeons (ASPS).</p><p>Now, as more celebrities discuss their plastic surgery procedures openly, we are seeing public figures also beginning to discuss these breast procedures, including a very recent post by <a target="_blank" href="">Amber Rose</a> on Instagram, <a target="_blank" href="">Queen Latifah's interview to People</a>, and <a target="_blank" href="">even Kris Jenner</a>.</p>


<p>I am often asked by patients about changes due in the breasts due to pregnancy and breastfeeding. In fact, a significant portion of cosmetic plastic surgery of the breast and body can be linked back to pregnancy, childbirth, and breastfeeding. Unfortunately, pregnancy is tough on a woman's body, and many changes are irreversible and unavoidable.</p>

Copyright 2017 Joshua D. Zuckerman, MD, FACS, P.C. All rights reserved.