What Treatment Options Exist For Correcting A Capsular Contracture After Breast Augmentation?

What is a Capsular Contracture?

Capsular contracture is a rare, but concerning complication of breast augmentation. While breast augmentation continues to be one of the most common aesthetic procedures undertaken in the USA, capsular contractors can and do occur. Capsular contracture refers to a process where your body forms an abnormally hard shell around your implant, causing pain, discomfort, and loss of the breast shape. While this complication is obviously concerning, we routinely treat this unfortunate complication at our facility for all types of patients. As with all types of plastic surgery, treatment of this problem begins with defining the problem and how it specifically effects you.

4 Stages of Capsular Contracture

Grade I Capsular Contracture

To begin, all breast implants cause creation of a capsule. The magnificent machine that is the human body recognizes the presence of a foreign body internally. It then creates a soft capsule around the breast implant that is completely organic and physiologic. This capsule is actually quite helpful for both patient and plastic surgeon, as it creates a permanent “home” for the breast implant. This type of capsule is considered a Grade I capsule. No treatment or surveillance is necessary at this stage. This is actually what both patient and plastic surgeon want to have. Grade I breast is normally soft and appears natural in size and shape

Grade II Capsular Contracture

When the capsule begins to thicken up, and the implant feels slightly firmer, but does not change its overall shape, the capsule is then considered a Grade II capsule. The good news is that surgery is usually NOT indicated. In these instances, we treat the capsule through medical and mechanical means only. Lymphatic massage, ultrasound therapy, and the use of Zafirlukast can often reverse thickening at this stage, and salvage your augmentation. Grade II breast is a little firm, but appears normal.

Grade III Capsular Contracture

The next stage of capsular contracture involves continued hardening of the implant capsule, but now the hardening has changed the overall shape of your implant and/or breast. Grade III breast is firm and appears abnormal. This type of contracture is considered Grade III, and is obviously extremely distressing to women, but it can be treated!! Treatment involves a careful balance of medical and surgical management, and as always, it relies upon wide open communication between our staff and you. In this stage, the capsule has created a mechanical compression of the implant. These patients do require surgical revision. As always, the type of surgery used is individualized to the patient, and we have a number of different approaches to choose from:

  • Partial Capsulectomy – This procedure involves removal of only a portion of the capsule. This is our least common procedure for treatment of contracture, but it does play a role for some patients who have a focused area of scar contracture. Typically, this type of procedure is done on patients who have not had appropriate unilateral descent of their implant. Surgery involves removing only the offending area of capsule. Post-operatively, patients are started on lymphatic massage and medical therapy. In appropriately selected patients, this treatment is very effective, but not all patients are candidates for this approach. We do not use surgical drains with this procedure.
  • Total Capsulectomy – This operation removes the entire capsule and all associated scar tissue with your existing implant. Once the implant and capsule are removed, a new implant is placed after the entire area is irrigated with a triple antibiotic solution. This type of procedure may also require a breast lift be done simultaneously, depending on the shape and size of the breast.
  • Neopectoral Pocket – This operation uses the abnormal capsule to our advantage! In this procedure the capsule is meticulously dissected free from the surrounding breast tissue and muscle. Once this is complete, the capsule is then collapsed down to the chest wall and oversewn to provide more projection and volume to the new implant. This is a fantastic approach to contracture, and it provides some of our best results. Unfortunately, a small 8mm surgical drain is required on each side for this procedure. The drain usually removed between days 3-5 after surgery. This is a highly specialized procedure that we perform.
  • Implant Plant Exchange with Strattice – There is a great deal of long-term clinical data that suggests that implants placed above the muscle may have more capsular contracture than implants placed below the muscle. If you have an above the muscle implant with contracture, the treatment of choice is total capsulectomy, removal of your current implant, and placement of a new implant beneath the muscle with a Strattice sling. This procedure is our most common form of revision, as it provides a soft, natural look to your breast. Strattice is a type of biologic mesh that revascularizes once inside your body. It essentially becomes part of the breast structure, providing a permanent internal support bra for your implant in its new position.
  • Implant Removal Only – This is a very viable approach to treating contracture, and while most clients wish to save their augmentation, many do not want to keep their implant. Removal of the entire implant without capsulectomy can be done with local anesthesia only. In this approach, the capsule is left behind, but it will commonly soften up over time. In cases where it continues to be hardened, secondary capsulectomy can be used at a later date to reduce internal scar burden.

Grade IV Capsular Contracture

The last stage of capsular contracture, Grade IV, involves a permanent dull throbbing pain, and commonly, a sense that the breast feels cooler to the touch. As with Grade III, your treatment options are the same. Patients again are maintained post-operatively on maximal medical therapy (massage, Zafirlukast). Use of total capsulectomy with Strattice sling is very common in this group. Grade IV – the breast is hard, painful to the touch, and appears abnormal

In summary, there are multiple treatment options available for women who have experienced capsular contracture of their breast implants. Treatment options vary from non-surgical treatment options to implant removal. Capsular contracture does not necessarily require permanent removal of the implant.

Exploring the Field Of Cosmetic Surgery in India

In recent years many people are going for cosmetic surgery to improve their appearance and thereby feel more confident. Men and women both are very conscious of how they look and the advancement of medicines has resulted in opening many ways so that in case a person is not happy with his or her looks or body they can very well get it transformed with the help of cosmetic surgery.

Though there are many people who try some traditional methods such as diet, workouts and lifestyle changes, there are many who resort to cosmetic surgery as the traditional methods often do not provide desired results. Some of the famous cosmetic surgeries which are in demand are facelift, lip reduction, octoplasty, Eyelift, breast surgery and so on.

As per researchers surgery originated in India in approximately 600B.C. Today India is again in news and is considered one of the best destination for getting cosmetic surgeries done. Some of the reasons why many people from within the country as well as from overseas are considering going for cosmetic surgeries in India are:

  • Growth of cosmetic surgery: As per statistics about 20,000-30,000 doctors are churned out by different medical colleges in India every year. The doctors need to complete a four and half year of bachelor’s degree and after that they need to do internship from a reputed medical college. In order to become a surgeon they again need to do a two year post graduation degree where they need to focus on their area of specialization. The rigorous medical course ensures that the doctors are equipped with the latest knowledge and are also aware of the latest technology. Cosmetic surgeon and other parts are also experts in their field with vast knowledge and can be trusted to do a great job.
  • Experts handling surgery in India: It is not unknown how a plastic surgery can go wrong if not done by experts. However, India’s private medical facilities are considered one of the best and the cosmetic surgeon in and other parts are experts in their field and can be trusted to give you the desired result. Cosmetic surgeries and other parts offer some of the best facilities. The technology that is used is world class making it a sought after destination for patients from all over the world.
  • Cheaper costs: Clients from many developed countries such as Britain, America and other parts of Europe have been flocking India so as to escape the high medical cost in their country. Medical cost in most of the developed countries is tremendous and as per experts it is quite less when it comes to India. So patients get the advantage of availing world class services at less cost due to the fact that the countries standard of living is low.
  • The scenario of India has changed a lot and the country is no longer lacking in technology. Moreover Indian doctors have international qualification as well as expertise which make them all the more experts in the field and they can be trusted to do fantastic job at cost which is almost 30-40% less than that of developed countries.

Although India is a great place to get cosmetic surgery done, one should research well before zeroing in on any particular doctor. The surgeon selected should understand your desires perfectly. Apart from qualification and expertise of the doctor, reference also helps in choosing the right doctor. He or she should be having expertise in similar type of operations that you want to be performed on your body.

What Can Cosmetic Surgery Do for My Skin and Eyes?

Cosmetic surgery is becoming more popular these days since most of the procedures performed have turned into mainstream. Such surgery improves the appearance or function of specific parts of the body. In this article, you will read about the descriptions of different cosmetic surgeries done to the face.

Skin

The skin is that area of the face that has a wide range of possibilities in terms of cosmetic procedures. Different types of cosmetic surgeries can be done on facial skin, which can even be combined for people who want various results. Some of the cosmetic surgical procedures done in this area include:

Face lift

As a person ages, the facial skin loses its elasticity, making it look loose and less firm. A face lift enables the skin to look tighter and more toned.

Forehead lift

The skin on the forehead can also be tightened by means of a forehead lift. This procedure results to the reduction of bags on the upper eyelids.

Thermage

Thermage is one of the cosmetic procedures that helps tighten saggy or loose skin. However, it does not leave any scars and has no downtime, not like a face/forehead lift.

Chemical peel

In this cosmetic procedure, a chemical exfoliation treatment is applied to the face. In the process, the top layers of the skin are removed, which results to skin that is softer and healthier looking.

Dermabrasion

Just like a chemical peel, dermabrasion aims to remove skin irregularities so that the patient can have softer, smoother skin. To accomplish this, dermabrasion makes use of a diamond rotary instrument.

Laser resurfacing

A carbon dioxide laser is used in this process. It is applied to the skin to reduce the look of facial lines and wrinkles.

Facial fillers

There is a wide range of filler products for the face, such as collagen, hylaform and restylane, among others. Such products can be injected into the facial skin to reduce the look of folds and wrinkles. These can also add more volume to the skin and make specific areas of the skin firmer.

Botox

Botox, just like fillers, is injected to certain areas of the face that have lines/wrinkles. However, unlike fillers, Botox does not fill up the space. Instead, it only weakens the muscles that bring about frown lines and wrinkles surrounding the forehead and eyes.

Eyes

Another common part of the face that patients would like to improve through cosmetic surgery is their eyes. They often choose to undergo these surgeries as they age, when they have a more wrinkled/saggy look. Cosmetic surgeries involving the eye area are the following:

Eyelid lift

Blepharoplasty or eyelid lift takes away excess skin and fat from the eyelids. This procedure can be done on the upper or lower eyelid or even both.

Eyelash transplantation

People who desire to have longer, fuller eyelashes can opt for the eyelash transplantation procedure. This makes use of a highly specialized method in adding or replacing living eyelashes into the eyelids.

Is the Mommy Makeover Trend Worth It?

In 2012, according to the American Society of Aesthetic Plastic Surgery, breast augmentation, liposuction, and the tummy tuck were the three most popular procedures. These three procedures all make up the Mommy Makeover. The mommy makeover has been an increasing trend in plastic surgery news, according to ASAPS statistics, women ages 35-50 received 40% of all the surgical procedures in 2012 and the majority of the mommy Makeover procedures in total: Breast augmentation 40%, tummy tucks 55.8%, and Liposuction 47%. This trend has gone viral in result of the recent news articles highlighting mommy makeovers and interviewing the moms and their families post-procedure along with the many celebrities jumping on the band wagon like reality TV star Kim Kardashian. So why exactly are moms considering the “Mommy Makeover”?

Mommy Makeover Trend

While many mothers are choosing diet and exercise after child birth, some have found that no matter the time and energy spent at the gym will help eliminate the sagging excess skin and pockets of fat left over from weight gained during pregnancy. Some women are perfectly okay with having the sagging skin as it is a reminder that they once had a miracle happen inside their body. However, some women just want their old slim pre-pregnancy bodies back and the Mommy Makeover is certainly one successful way to do so. According to Realself.com, a community of members who share their procedure stories and real doctors who answer questions, the mommy makeover has a 98% “Worth-it Rating. The “worth-it rating” meant that those who have had a mommy makeover on average say that the procedure was 98% worth-it to do. Mother of two, Angela Aguirre, had the same idea. Angela began working out and exercising regularly to achieve as much success with her body as she could, she managed to lose 30 pounds. Angela worked extremely hard to lose those 30 pounds but when she looked in the mirror, all she saw was loose skin and her “stomach didn’t look any different”. Angela’s results were not exactly what she expected, she says “there was loose skin, and it kind of had a round, potbelly appearance to it. I’d been working out really hard for a year and three months and thought, ‘Surely by now it would be tighter'”. Except they weren’t and she could not figure out what was going on. Her next step was to visit her family doctor to figure out what was going on, he said after she her two C-sections, her stomach muscles became separated and that there was nothing she could do to fix that other than having a tummy tuck.

Risk and Complications

On top of self-esteem and confidence, it seems that the trend in mommy makeovers are soaring because of problems like Angela has experienced with her two c-sections. Aguirre believed it was a matter of personal preference and that she noticed her self-esteem has gotten better”. A big question that came to Aguirre was if the mommy makeover was worth the risks that come from a major surgery. Not only was Angela receiving one major surgery, she was having two major surgeries while some women opt in for three, a tummy tuck, breast augmentation or breast lift and liposuction. However, because the mommy makeover is an “all-in-one” package, these surgeries are all performed at one time, somewhat reducing the risks instead of having three separate surgeries. Risks from the mommy makeover can encompass many risks and complications similar to any surgical procedure. The procedure can take from four to eight hours to complete, depending on the type of procedures included. Your surgeon will conduct a detailed review of your medical history and if a patient has certain risk factors, the surgeon will proceed accordingly. Risks such as bleeding, infection, incision scarring, abnormalities, and even depressions from unrealistic expectations are just a few examples. Unrealistic expectations, however, can be avoided if the surgeon ensures the patient is stable mentally and physically.

For Angela Aguirre these risks were worth it stating “the way I look at it, it was six weeks out of our lives. Now I can be happy for the rest of my life. It’s a good trade-off.” Angela was very lucky to be able to find a plastic surgeon that was perfect for her. Because of such risks of complications from having major surgery, it was very important for Aguirre to choose a board certified surgeon with years of training, education, and experience. The list of risks and complications from a mommy makeover are minor when it comes to allowing any surgeon or “surgeon” to perform on your body. These risks can easily jump from bleeding and infections to possible death. This is why the American Society of Aesthetic Plastic Surgery always advises consumers to do their research and consult with a board certified plastic surgeon.

Background Information On Labiaplasty

Labiaplasty is a form of surgery that involves reducing the size of the flaps of skins that are found on either side of your lady parts. The reasons behind having this surgery are mostly cosmetic, with some women being uncomfortable with their size, or some hating the way they look. If you are considering having it done, you should be aware that it is perfectly normal for most women to have these extra folds of skin. It is nothing to be ashamed of.

In terms of costs, it costs more than most cosmetic procedures. This is because of the amount of risks that are involved with the procedure. Before booking an appointment with any surgeon, it is important that you go over the risks with your doctor because he / she may be in a better position to inform you on whether or not undergoing the surgery will be the best decision for you. If there is nothing wrong, you may want to consider talking to a counselor before you commit yourself to surgery.

Cost

Depending on the size of your lady parts, and whether there are other complications involved, the cost of having surgery done varies from patient to patient. On average, it can cost anywhere between $ 2000 and $ 9000. There may be other costs such as follow up appointments or initial consultations that may not be included in the figure quoted. Always ask for information on any additional costs you may incur before check to the surgery. The NHS may cover some of your costs only if they feel that your lady parts are abnormal or pose a threat to your health. Other than that, you would be responsible for funding the surgery.

Choosing a Clinic

With the number of cosmetic surgery clinics, it can seem almost next to impossible to find the one that would suit your needs. You could narrow it down by looking at certain factors. One of them is the kind of qualifications they have. If possible, ask whether they are a part of a recognized association such as the Australian Society of Plastic surgeons. They have to be certified to be legally allowed to practice. You also need to ask regarding the number of successful surgeries they have conducted over the course of three years. This will help you gauge whether they have the right skills to perform the surgery on you.

During the Procedure

The surgery involves reshaping or shortening of your lady parts. Either general or local anesthetic may be administered. The whole surgery can be done in less than 2 hours. The unwanted parts will be shortened using either a scalpel or a laser.

Recovery

You will require several weeks or a couple of months to fully recover. You may need to take some time off work. During this healing process, you are required to keep the area clean to prevent infection. Avoid wearing tight clothes that may constrict movement and prevent air flow. Avoid any intimacy with your partner for a couple of weeks.