October 28th, 2010 Dr. Taleisnik
Capsular Contracture In Orange County
Breast augmentation is an extremely popular procedure for good reason: most women are very happy with their results, and with their decision to undergo this surgery. One of the conditions that can lead to dissatisfaction is capsular contracture, although this too can often be treated and improved.
The human body will naturally form a membrane or tissue layer around any foreign object. We call the layer that forms around a saline breast implant or silicone breast implant the “capsule.” There is always a capsule around any breast implant, but usually the capsule remains thin and soft. Occasionally, the capsule tightens and thickens, or “contracts,” around the implant. This can cause the implant, and the breast, to feel too hard. Capsular contracture can push an implant out of its proper position, creating a breast asymmetry. It can also produce an abnormal breast shape, or a very unnatural appearance to the breasts. At times, capsular contracture can be painful.
The cause of capsular contracture is not fully understood, despite extensive research on this topic. Certain factors that increase the likelihood of developing capsular contracture have been identified, however. Excessive bleeding around the implants immediately after surgery, touching the implants with gloves that are coated with powder, and patient smoking are some of these factors. Some surgeons believe that, if a breast implant is placed in front of the muscle, a textured implant may have a lower contracture rate than a smooth implant. Some surgeons also recommend massaging the implants after surgery, although it’s not established that implant massage makes a measurable difference. Clearly, there are things that your surgeon can do, and things that you can do (avoid smoking!), to decrease the chances of a capsular contracture.
Even when all precautions are taken, however, some women will still develop capsular contractures. As a plastic surgeon specializing in breast augmentation and breast revision surgery, I frequently treat patients for this problem. A “capsulectomy” is a surgical procedure that involves cutting out the capsule and scar tissue, leaving behind soft breast tissue. It’s basically like starting over. Some women may again develop a capsular contracture after the capsulectomy, but many will not. It’s very important to avoid smoking if you are undergoing a capsulectomy. Some surgeons prescribe a medication called Singulair when operating on a patient with a capsular contracture. This is actually a medication for asthma, but many doctors believe that a beneficial “side effect” of Singulair is a reduced rate of capsular contracture. When undergoing a capsulectomy, the implants may also be replaced, so that they are brand new, with no wear or bacteria. The implant size can be changed too if desired. Sometimes, the capsular contracture may be holding the implants and breasts up, giving a perky appearance even though the breasts are too hard. Once the scar tissue is removed, the breasts may look more ptotic, or droopy. To counteract this, it may be helpful to use a larger implant, or to include a mastopexy, or breast lift.
To give yourself the best chances for a great outcome after breast augmentation, or to obtain treatment if you’ve already developed a capsular contracture, it’s critical that you consult a plastic surgeon certified by the American Board of Plastic Surgery, the only organization that board certifies fully trained and experienced plastic surgeons. I treat patients with capsular contracture (and other problems after breast augmentation) from throughout Orange County, Los Angeles County, Riverside County, San Bernardino County and elsewhere. If you’d like to schedule a consultation to meet with me, either for a first-time breast augmentation or a revision surgery, please call my Newport Beach area office at 714-835-6500. Please also visit my website for more information: ataleisnikmd.com.
Posted in Breast Augmentation, Breast Implants, Breast Lift Surgery, capsular contracture, Home | 1 Comment »
November 5th, 2009 Dr. Taleisnik
Breast Lift Specialist Orange County
Serving Newport Beach, Riverside County, San Bernardino County, Los Angeles County
Unfortunately for our bodies, gravity is always pulling. This leads to drooping eyelids, drooping faces, drooping tummies, and yes, drooping breasts. Big breasts tend to droop or sag more than small breasts as time passes, but no breast is immune. There are other important reasons that breasts can droop. Pregnancy is a major cause of breast drooping (medically referred to as “ptosis”). I’ve recently written several articles about “The Mommy Makeover,” a combination of procedures (including breast enhancement) designed to counteract the effects of pregnancy and breastfeeding. Some women develop breasts with unsatisfactory shapes, often with ptosis, right from the start, during puberty. Other women experience severe breast drooping after losing large amounts of weight. Fortunately, procedures are available to improve all of these problems.

Breast drooping, or ptosis, is usually improved with a surgery known as a mastopexy, or breast lift. A mastopexy can raise the nipple and the areola (the darker skin around each nipple) to the appropriate height. It can help to restore cleavage, lift the breast off the chest wall, and improve the appearance and feel of breast fullness. If the areola diameter is too big, the areolas can be reduced to a more pleasing size. Many women tell me that it’s much easier to find properly fitting bras, and attractive swimsuits or clothing, after undergoing a breast lift.
The first step is to determine whether you actually need a breast lift, or if your breasts are simply “empty” or “deflated,” as can often occur after pregnancy and breastfeeding. Many patients who see me in my Orange County office requesting a breast lift actually benefit more from a breast augmentation. It’s important to consult a plastic surgeon certified by the American Board of Plastic Surgery if you’re thinking about enhancing your breasts. Your surgeon must have the necessary education, training, experience, and judgment to help you to decide which procedure will provide the improvement you desire. Certainly, there are many women who do require a lift, and others who benefit most from breast augmentation in combination with a breast lift. A breast lift alone may not be able to restore the volume and upper breast fullness that some women seek. For such patients, adding implants to a breast lift can produce beautiful results.
Any breast lift will create come scarring on the breast. In most patients, the scars fade and become fairly inconspicuous with passage of time. Some patients, however, will form scars that remain more visible (but not in clothing or a swimsuit). There are different types of lifts, each producing different degrees of scarring. Many factors determine which type of lift is appropriate for any given patient.
When ptosis, or breast drooping, is quite severe, patients require a traditional type of mastopexy, or lift. This type of lift creates more scars, but is also very powerful. The breasts can be totally reshaped and repositioned with a full mastopexy. Once again, it may be helpful to add implants as well to improve upper breast fullness and cleavage.
I often perform a modified type of breast lift for my patients undergoing breast augmentation who also require slight tightening of the breast skin and slight elevation of the nipples and areolas. This is referred to as a “concentric mastopexy.” This type of lift creates a scar around the areola only. Since the scar is at the border of two different colors and textures of skin, it tends to blend in well. Photos illustrating this can be seen on my website
If your breasts are heading south, or if you’re unhappy with them in any way, please don’t hesitate to contact my office at 714-835-6500. We can arrange a free consultation, where I can help you to decide the best way to obtain the improvements you want. I evaluate and treat patients from all over Newport Beach and Orange County, Riverside County, San Bernardino County, and LA County, as well as patients from other states, who are dissatisfied with their breasts. I look forward to helping you too.
Posted in Breast Lift Surgery, Home, Mommy Makeover | No Comments »