It’s widely known that Capsular Contracture can occur in patients who have breast implants. This is the time when patients can choose to remove their saline implants and replace them with silicone implants. Often we discuss with the patient the option to improve the position of the implants at this time.
While many reasons contribute to a capsular contracture, I find that the more common reasons tend to be:
- history of hematoma or undetectable hematoma
- history of previous infection or subclinical infection
- long duration of implant placement
- patient specific factors (i.e. prone to keloid, hypertrophic scar, capsular contracture, etc.
In patients who have a history of recurrent capsular contracture, despite previous capsulectomy, I add the the following management plan:
- At the time of capsule surgery, the implant is removed and the implant pocket is cultured.
- Post-operatively, the patient is placed on Keflex if able to tolerate, or clindamycin if there is a cephalosporin allergy.
- If the culture result is a bacterium not sensitive to Keflex or Clindamycin, then an antibiotic is chosen to fit the appropriate bacteria.