Correction of Capsular Contracture with Implant Exchange and Capsulectomy, NC*

Capsular contracture of breast implants is an abnormal condition where unfavorable scarring around breast implant can create a firm unnatural appearance even causing pain. Formation of a capsule is a normal response that occurs around any foreign body implanted in our body. It is the natural healing that essentially walls off the implanted object and occurs in joint replacements, artificial valves breast implants and other surgically implanted devices. Capsular contracture has 4 categories known as Baker grade. The most severe cases, Baker grade 3 causes the breast to be firm to the touch and have an overly rounded appearance distorting the breast. Grade 4 is associated with pain. This 76-year-old woman had breast augmentation mastopexy with gel implants performed by another surgeon about 7 years ago. In the last 3 or 4 years she developed painful firmness in the left breast. Dr. Lyle treated the condition by removing the left breast implant as well as the thickened capsule that was present. He replaced it with a new implant and used a surgical mesh known as xenograft called Strattice™ which is actually sterilized porcine dermis. This material tends to markedly reduce the chance of a recurrent encapsulation. Her postoperative result was a softer natural appearing breast. There are many proposed causes of capsular contracture but it is believed that inflammation around an implant caused by low grade bacterial colonization or blood or serum in the pocket.