December 1980, Volume 4, Issue 1, pp 267–272Capsular contracture and steroid-related complications in augmentation mammoplastyDOI: 10.1007/BF01575226Cite this article as: Cohen, I.K. & Carrico, T.J. Aesth. Surg. (1980) 4: 267. AbstractAn analysis of the data obtained in 91 of 161 patients (57%) who had undergone augmentation mammoplasty between 1973 and 1978 demonstrates that corticosteroids should be used with caution and that more data are needed before their efficacy is assured. Moreover, the authors believe that a better understanding of the breast contracture mechanism and specific pharmacologic agents is necessary in order to control the process of capsular contracture.Massaging Breast Implants After Surgery The theory behind massaging your breasts after breast augmentation surgery is to try and reduce the risk of capsular contracture; a condition that was once the biggest concern with breast augmentation surgery, which can cause the breast to be hard, painful and misshapen.
It is believed by some plastic surgeons that if the implant pocket is kept larger than the implant by frequently moving the implant around inside of the pocket, the scar capsule will not shrink and compress the implant, which is what a capsular contracture is. To my knowledge, no reliable medical study has ever been published in the plastic surgery literature that proves that massaging your breasts after surgery reduces the risk of capsular contracture. Despite this, many surgeons still recommend breast massage to their patients. It is truly unfortunate that some surgeons actually blame their patients for getting a capsular contracture by claiming that they didn’t massage their breasts enough after surgery. The honest truth is that capsular contracture is an enigma in plastic surgery of the breast. It is generally accepted that excess bleeding leaving blood in the pocket around the implant can increase capsule formation. For this reason as well as to reduce the risk of bleeding during and after surgery, it is strongly recommended to avoid any medication that can thin you blood for two weeks before surgery.
This includes aspirin, Vitamin E, ibuprofen, Advil and other anti-inflammatory medications as well as many herbal medications. Other theories include the idea that capsule formation has to do with biofilms created by microorganisms. This is a relatively new concept in medicine and surgery. Bacteria can attach to an implanted prosthesis and form a film on the surface of the implant, which allows them to live and multiply without being attacked by the body’s immune system. The concentration of bacteria is not enough to cause an actual infection, but is enough to stimulate the formation of a firm capsule and, hence, a capsular contracture. For this reason and to avoid the risk of infection of breast implants, most surgeons recommend the use of antibiotics for at least a few doses around the time of surgery and it is becoming more common practice to irrigate the implant pocket with a dilute solution of antibiotics to not only reduce the risk of clinical infection but also to reduce biofilm formation and
, hopefully, reduce the development of a biofilm. If your surgeon recommends that you take antibiotics around the time of surgery, you are encouraged to follow those instructions; not only to reduce your risk of implant infection but also to potentially decrease capsule formation. One of the most confusing things about capsular contracture is that it frequently occurs only on one side. It is hard to imagine why one breast stays soft and the other gets hard when they were put in the same patient, at the same time, by the same surgeon and identical implants were used on both sides.Mastopexy is the medical term for a breast lift. This procedure is performed on patients who have lost weight, had multiple pregnancies, or had the development of droopy breasts since puberty. The procedure is associated with scarring. It takes approximately one and a half hours. It is done under a general anesthetic. The recovery time until the patient is able to function for normal day-to-day activities is approximately one week.
To full exercise recovery it is approximately two to three weeks. There are many different styles of a breast lift, but the procedure is very effective in reducing the affects of gravity and pregnancy. Breast lift (mastopexy) surgery is designed to uplift and improve the shape of breasts. The natural shape of breasts may gradually change with time. Breasts can lose elasticity with age, pregnancy, or fluctuating weight. This may leave some women dissatisfied with the shape of their breasts and wishing to restore their youthful look. Candidates for mastopexy are women whose breasts have lost tone and volume due to aging, pregnancy or weight loss. If the areola (pigmented skin around the nipple) is stretched or enlarged, a breast lift will reshape and reposition the nipple to a more youthful size and position. It is very important that Dr. Van Laeken is aware of the state of your general health prior to surgery. Please let her know of any allergies you have, medications, herbal supplements, or vitamins you are taking as well as the reasons for taking them.
It is also important that you inform Dr. Van Laeken if you have a tendency for keloid scarring (thick, wide, or raised scars).If you are a smoker we encourage you to quit prior to proceeding with surgery. Smoking can interfere with the blood flow to the skin, and will inhibit the healing of the incisions. Depending on your age as well as your general health pre-operative tests may be ordered, such as blood tests, or an ECG. It is important that you avoid taking vitamin E, anti-inflammatories or aspirin products for 2 weeks prior to surgery. These products are anti coagulants, and could lead to hematoma formation and bleeding during the surgery. Dr. Van Laeken operates at several different hospitals, but generally performs mastopexy surgeries at False Creek Surgical Centre or the Cambie Surgery Centre. These are both state of the art, fully accredited private surgical facilities. The operation is usually carried out as a day care procedure under a general anaesthetic.
Mastopexy surgery does not remove any breast tissue, but may involve the removal of skin to re-position the nipple and lift the glandular tissue on the chest wall. In some instances, patients request having their breasts augmented as well as uplifted. There are many variations on the mastopexy procedure. The time required for the surgery varies from one to two hours, depending upon the extent of surgery required and whether or not an implant is placed. The cost will also vary depending upon the nature of the procedure. Each case is taken on an individual basis. Patients are examined and recommendations are made based on the patient’s breast shape, size, skin tone, age and cosmetic desires. If the patient chooses to have breast implants placed at the time of the lift, then information regarding breast augmentation will be given to the patient at the same time. For more information visit the Natrelle website. Each of these techniques involved some degree of scarring. These scars will be covered by your brassiere and should diminish with time.
Breast Lift With Implants Following your surgery your breasts will be swollen. This swelling will last approximately 2-4 weeks. You will be given a prescription for pain relievers, take as directed. Immediately post-operatively you will be placed in a compression bandage, which is not to be disturbed until you are seen in the office 5-7 days after surgery. When you arrive home after surgery Dr. Van Laeken recommends that you rest in bed. Placing ice packs on your chest will help reduce bruising, swelling, and help keep you comfortable. Most patients who have sedentary jobs plan to take 2 weeks off work. If your job involves a great deal of physical activity Dr. Van Laeken can advise you as to how much time you should take off. The first follow-up appointment is in the office 5-7 days after surgery. The dressing is removed at this visit. You may notice some numbness around the breast once the dressing is removed. Bring a jog bra or aerobics top to the first post-op visit.