Capsular Contracture Surgery in Nashville, TN
If your breast implants have started to feel unusually firm, look distorted, or cause ongoing discomfort, you may be dealing with capsular contracture, one of the more common complications of breast implant surgery. It isn’t dangerous, but it also isn’t something that improves on its own, and it can take a real toll on how your breasts look and feel.
The good news is that capsular contracture is treatable. Dr. Michael Cash has extensive experience correcting contracture for patients throughout the Nashville area, helping them get back to breasts that feel soft, natural, and comfortable again.
To find out whether surgery is the right next step for you, contact Nashville Plastic Surgery or call (615) 454-2271 to schedule a consultation with Dr. Cash.
What Is Capsular Contracture?
When a breast implant is placed, your body naturally forms a layer of scar tissue around it that is a normal, expected part of healing, and it’s what holds the implant in position. In most patients, this tissue, called a capsule, stays thin, soft, and flexible and you’d never know it was there.
Capsular contracture happens when that scar tissue thickens, tightens, and hardens instead. As the capsule contracts, it squeezes the implant, which can change the shape of the breast, make it feel firm to the touch, and in more advanced cases, cause visible distortion or discomfort. It can happen on one side or both, and it can show up months or even years after your original augmentation.
Capsular contracture is usually described using the Baker grading scale, from Grade I, meaning soft, no visible change, up through Grade IV which is hard, painful, and visibly distorted. Grades I and II usually don’t require treatment, but Grades III and IV are where surgery typically becomes the recommended path forward.
How Do You Know If You Have Capsular Contracture?
Capsular contracture can develop gradually, so many patients notice small changes before they piece together what’s going on. Common signs include:
- Firmness: Your breast feels harder than it used to, almost like the implant is sitting right at the surface.
- Shape changes: Your breast(s) may look rounder, higher, or more distorted than the other side.
- Visible asymmetry: You may notice changes that make your breasts look asymmetrical when they used to match.
- Tightness or discomfort: Your breasts may feel “off” when lying down, exercising, or engaging in certain movements.
- Pain: You might be experiencing pain ranging from mild tenderness to more persistent discomfort.
If any of this sounds familiar, it’s worth having Dr. Cash take a look. Not every firm-feeling breast is contracture, and an exam is the only reliable way to know what’s actually happening and how advanced it is.
Am I a Candidate for Surgery?
You may be a good candidate for capsular contracture surgery if you:
- Have noticeable firmness, distortion, or pain in one or both breasts following implant surgery
- Have been diagnosed with, or suspect, Grade III or Grade IV capsular contracture
- Are unhappy with the shape or position of an implant affected by scar tissue
- Are in good general health and ready for another surgical procedure
- Understand that capsular contracture can, in some cases, recur even after treatment
Dr. Cash will confirm your Baker grade and go over your specific case during a consultation, including whether your original implants, your surgical history, or other factors may be contributing.
At Nashville Plastic Surgery, our mission is to treat you with the utmost respect, help you make an educated decision, and provide you with the finest medical services in a safe and professional environment.
Dr. Cash, our board-certified plastic surgeon, specializes in breast augmentation, tummy tuck, liposuction, and more. Schedule a consultation today to learn more!
What Are Your Capsular Contracture Treatment Options in Nashville, TN?
There’s more than one way to approach capsular contracture, and the right one depends on how severe your specific case is, whether you want to keep your implants, and your overall breast health. Dr. Cash will walk you through which of these fits your situation during your capsular contracture consultation when he’s about to get a closer look.
Capsulotomy
For milder cases, capsulotomy involves surgically scoring or releasing the tightened capsule to relieve pressure on the implant, without removing the tissue entirely. This is a less extensive option, but it’s typically reserved for less severe contracture and carries a higher chance the tightening could return.
Capsulectomy
For more significant contracture, Dr. Cash typically recommends a capsulectomy, which involves surgically removing all or part of the hardened capsule. A capsulectomy thoroughly addresses the problem tissue and tends to offer more lasting relief than a capsulotomy alone. Depending on your case, this may be done as a total capsulectomy or a partial capsulectomy.
En Bloc Capsulectomy
In certain circumstances, the capsule and implant are removed together as a single, intact unit in a technique called called en bloc capsulectomy. This approach is generally reserved for specific situations, such as concern about implant rupture or other complications, rather than being a routine default for every case of contracture.
Implant Exchange
Many patients choose to have new implants placed at the same time the capsule is treated, rather than going through recovery twice. This is also a natural opportunity to reconsider implant size, type, or placement if your preferences have changed since your original surgery.
Removal Without Replacement
Some patients decide they’re ready to be done with implants altogether. In that case, Dr. Cash removes the capsule and implant without placing a new one, sometimes combined with a breast lift or fat transfer to help restore a natural contour to the breast.
What Can You Expect on the Day of Your Capsular Contracture Surgery?
Capsular contracture surgery is performed under general anesthesia, usually taking 1 to 2 hours depending on how extensive the capsule removal needs to be and whether implants are being replaced. Dr. Cash generally reopens your original incision when possible to avoid creating new scars. From there, he carefully removes the hardened tissue, addresses any changes to the implant pocket, and either places a new implant or closes the site if implants aren’t being replaced.
You’ll go home the same day, so you’ll need someone to drive you and stay with you overnight, and possibly for the first few days while your recovery as your arm mobility will be somewhat limited.
What Is Recovery After Capsular Contracture Surgery?
Recovery is often a bit more involved than a first-time augmentation, since there’s more tissue work taking place. During your capsular contracture surgery recovery, you can expect:
- First few days: Swelling, bruising, and soreness that’s typically more noticeable than after a straightforward augmentation. Prescribed pain medication usually keeps this manageable.
- First 1 to 2 weeks: You’ll wear a supportive surgical bra and should plan on taking at least a week off work, and longer if your job is physically demanding.
- Weeks 2 to 4: Gradual return to light daily activity, with continued improvement in softness and comfort.
- Six weeks and beyond: Most patients are cleared for full exercise and higher-impact activity, once Dr. Cash confirms healing is on track at your follow-up visits.
Because scar tissue can theoretically re-form, Dr. Cash will also talk with you about steps that may help lower your risk of recurrence going forward, and he’ll want to see you for follow-up visits to monitor how your breasts are healing.
Schedule Your Capsular Contracture Consultation with Dr. Michael Cash Today
Every capsular contracture case looks a little different, which is why your consultation with Dr. Cash starts with a thorough exam. He will examine your breasts and assess the severity, or Baker grade, of your contracture, review your surgical history, including implant type, size, and placement and talk through your goals.
To learn more contact Nashville Plastic Surgery online or call (615) 454-2271 to schedule your consultation.
Capsular Contracture FAQs
The exact cause isn’t fully understood, but it’s thought to involve factors like low-grade bacterial contamination around the implant, bleeding during the original surgery, or an individual’s own healing response because every heals and scars differently. It isn’t caused by anything that you did wrong.
It isn’t considered a health emergency, but it can cause real discomfort and cosmetic changes that many patients want addressed as soon as possible. Severe contracture should generally be treated surgically rather than left alone.
Yes, it’s possible, particularly after a capsulotomy rather than a capsulectomy. Removing more of the capsule tissue, along with certain surgical techniques Dr. Cash uses, can help lower a reoccurrence, although not eliminate the chance of recurrence.
Grading is done through a physical exam done by a professional plastic surgeon. Generally, Grade III involves visible firmness and some distortion without much pain, while Grade IV adds noticeable pain to those changes. Dr. Cash can assess your grade during your visit.
That’s entirely your choice. Some patients replace their implants at the same time the capsule is treated, while others use this as the moment to go implant-free, and it is sometimes combined with a lift or fat transfer to keep a natural look.
Capsular contracture treatment is sometimes considered medically necessary, particularly at higher grades with pain involved, which may make it eligible for partial insurance coverage depending on your plan. Our office can help you look into this during your consultation and scheduling.
Many patients experience lasting improvement, especially with capsulectomy rather than capsulotomy. That said, no surgery can guarantee contracture will never develop again, which is why Dr. Cash builds in follow-up visits to catch any changes early.
Usually not significantly more. Dr. Cash typically works through your existing incision whenever possible, rather than creating a new one.
Light daily activities generally resume within 1 to 2 weeks, with a full return to exercise, including upper-body movement, around six weeks, similar to, but sometimes slightly longer than, recovery from your initial augmentation.