Every time a breast implant is placed, the body heals around the implant by forming a lining that we call a capsule. Capsular contracture refers to tightening around the breast implant that can cause the breast to become firmer and the implant position to move up. The exact cause of capsular contracture is unclear, although inflammation following surgery (either from bacterial contamination or bleeding around the implant) is generally felt to be the cause. Unfortunately there is no way to know in advance who might get a contracture, and presumably there are genetic differences that come into play. Some surgeons believe that using implants that are too large or are poorly fitting may be a cause.
Capsular contracture is the most common complication in breast augmentation patients with 5% of patients experiencing it. While capsular contracture cannot be completely prevented, Dr. Slenkovich has carefully developed his own steps to decrease the chance of capsular contracture in breast augmentation patients before, during and after surgery. We call it our “capsular contracture voo-doo” devised to provide patients with exceptional care and the safest breast surgery possible.
Before Breast Augmentation Surgery:
- Proper breast implant size – Dr. Slenkovich and the clinical staff at Colorado Plastic Surgery Center work with each breast augmentation patient to ensure they have the appropriate size of breast implants. During the consultation he carefully measures the patient’s breast width to find an implant size that will best achieve her breast enhancement goals, while decreasing the chance of capsular contracture with a well fitted breast implant size and profile.
- Avoiding aspirin and Fish Oil – Several days before surgery breast augmentation patients are asked to avoid taking aspirin, fish oil and other medications and supplements that contribute to bleeding or oozing.
- Hibicleans antibacterial soap – The morning of surgery breast augmentation patients are asked to shower and wash their torso and underarm area with hibicleans, a surgical grade anti-bacterial soap, that is provided during the pre-operative appointment.
During Breast Augmentation Surgery:
- Limiting the traffic in and out of the operating room during surgery ensures a sterile environment for breast implants.
- Our state licensed surgery center complies with the most rigorous safety, sterilization, filtration and ventilation standards. Some plastic surgeons perform surgery in “office-based” surgical facilities. The facilities fall under an exemption to Colorado state law requiring licensing of surgical facilities, and very few of these “office-based” operating rooms meet the strict requirements needed for state licensure (even though they may be accredited by a national organization).
- Strict sterile operative protocols are used and emphasized at all times, including using an additional layer of adhesive drapes to “seal off” the operative field. Dr. Slenkovich has performed performed hundreds of cases with the operating room staff and our staff is very familiar with breast implant surgery, capsular contracture avoidance and the reasons for strict sterile technique.
- Limiting the breast implants exposure to the environment before they are inserted into the patients body. Each breast implant is prepackaged in twice sealed sterile packaging by the manufacture. The outside wrapping, which can house dirt and dust, is removed before the breast implant package is brought into the operating room. Just prior to placement, the second layer of packaging is removed from the breast implant. Dr. Slenkovich is the only person to handle the breast implant to further limit the chance of contamination.
- Just prior to placement, Dr. Slenkovich changes gloves to reduce the chance of any contamination on the breast implant.
- A triple antibiotic wash solution is used to re-clean the breast area just before the implants are placed into the breast pockets, and the exposed area of the chest is “prepped” yet another time with antibacterial surgical prep solution.
- Meticulous control of bleeding during surgery reduces unnecessary blood retention in the breast implant pocket. Dr. Slenkovich is extremely particular about having the breast implant pocket completely dry before placing an implant.
- Placing the breast implant under the pectoralis muscle reduces the chance of capsular contracture by half, and is Dr. Slenkovich’s preferred placement option for breast implants rather than over the muscle.
- Antibacterial “Steri-strips” on incisions – After surgery, the OR staff places steri-strips over the incision site to prevent infection at the site, which can increase the risk of bacterial contamination around the implant.
After Breast Augmentation Surgery:
- Limiting strenuous activity and heavy lifting, which can promote bleeding around the implants, may decrease the chance of capsular contracture.
- Peri-operative light touch therapy for breast surgery patients circulates lymphatic fluid, promotes healing and prevents swelling and bruising. During these appointments our peri-operative treatment therapist, Pam, teaches each patient light-touch breast massage techniques that work to further prevent capsular contracture.
- Taking oral antibiotics after the breast augmentation surgery. Antibiotics are given to each patient to take after surgery to prevent infection at the incision site.
For more information on breast augmentation in Denver or how we strive to prevent capsular contractor, contact our office today to speak with a patient coordinator and to schedule a consultation with Dr. Slenkovich.
