Capsular fibrosis caused by breast implants – symptoms and treatment

What is capsular fibrosis?

Capsular fibrosis is one of the most common complications after breast augmentation with implants. The human body reacts to foreign bodies – including breast implants – by forming a capsule of connective tissue. This reaction is in itself a normal and natural defense reaction of the body. The capsule formation itself is not problematic; however, the real problem arises when this protective capsule begins to harden and thicken over time. This hardening, or capsular fibrosis, can lead to a variety of symptoms and affect the comfort and aesthetic result of the implant. But very important: not every woman who opts for breast implants also develops capsular fibrosis!

Causes of capsular fibrosis: Why does capsular hardening occur?

There are many causes of capsular fibrosis. The implant itself is perceived by the body as a foreign body. It therefore forms a layer of connective tissue around the implant for protection, which in rare cases can harden and lead to painful deformations. Bacterial infections can also cause an inflammatory reaction that promotes the formation of capsular fibrosis. Bleeding or a hematoma after the operation can also lead to the formation of capsular fibrosis. However, the incidence of capsular fibrosis following breast augmentation has fallen sharply thanks to modern implants and techniques.

Symptoms of capsular fibrosis: How does the change in the breast manifest itself?

There are various criteria that can indicate the formation of capsular fibrosis. As soon as women notice changes after their breast surgery, they should always consult their plastic and aesthetic surgeon to clarify the possibility of capsule formation.

The most obvious symptoms of capsular fibrosis are

• a possible deformation.
• an increasing hardening of the breast,
• Pain (when the hardened capsule presses on surrounding tissue) and

Severity of capsular fibrosis

Capsular fibrosis is classified into different degrees of severity based on its severity and the associated symptoms. The classification is usually divided into four grades according to Baker:

Grade I

The breast tissue is soft, looks natural and does not cause any pain. At this stage, there are no external signs of capsular fibrosis.

Grade II

The breast is slightly firmer than normal, but retains its natural shape. Minor hardening may occur, but there are usually no visible changes or discomfort.

Grade III

Here the breast becomes significantly harder and can lose its shape, making it appear unnatural. This degree of capsular fibrosis is often associated with pain and discomfort.

Grade IV

This is the most severe degree of capsular fibrosis. The breast is severely hardened, painful and looks clearly deformed. There may be a visible asymmetry between the two breasts.

The treatment of capsular fibrosis

There are several treatment options for capsular contracture. In the early stages, it can sometimes be sufficient to split the capsule through small incisions to make room for the implant. In severe cases, however, it may be necessary to remove the capsule including the implant. It is then possible to insert a new breast implant as part of the same procedure or to remove the excess tissue with a breast lift. Alternatively, breast augmentation with autologous fat can be considered.

How is capsular fibrosis surgically removed?

The implant change with removal of the hardened capsule is performed under general anesthesia. The incision is made over the existing scars so that no additional scarring occurs. The patient can choose between the same implant as before or other volumes or implant shapes. The procedure takes about 1-1.5 hours. Aftercare is similar to that of the first operation.

Preventing capsular fibrosis: How do I prevent painful changes to the breast?

The risk of capsular fibrosis used to be significantly higher than it is today. This is partly due to new, tissue-preserving surgical techniques, but also to modern implant materials. Implants now have a textured surface. Nevertheless, capsule hardening can occur in rare cases. To further minimize the risk, you should observe the following:

• Treatment by an experienced breast surgeon
• Implant position under the pectoral muscle
• Follow the doctor’s instructions for proper aftercare
• Regular check-ups

To completely rule out capsular fibrosis after breast augmentation, breast augmentation with autologous fat is a good alternative. It enables a moderate increase in breast volume. The result is absolutely natural and – as it is exclusively the body’s own material – capsular fibrosis cannot form in the first place.

Specialist advice on capsular fibrosis in Frankfurt

Capsular fibrosis is a serious complication after breast augmentation with implants. However, the risk can be minimized through education, precautionary measures and proper aftercare. If you notice any signs of capsular fibrosis, you should act immediately. As a specialist in plastic and aesthetic surgery, I specialize in breast surgery with minimal risk of capsular fibrosis. If you suspect that you have developed capsular contracture, please arrange a prompt appointment at my Frankfurt practice DOCTOR NAURAS ABUAGELA – I will be happy to help you.

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