All breast implants, once placed in the body, get a capsule made up of scar tissue surrounding the implants. This scar tissue is meant to protect you, the organism, from the breast implant, the invader. If the capsule is thin and loose, then your breast implants jiggle and your breasts are soft and natural. On the other hand, if the scar tissue around your breast implants become thick and/or they contract, then the process is referred to as capsular contracture. This is a circumferential or 360 degree inward contracture, causing the breast to feel hard.
To understand why the breast feels hard, try this experiment. Partially fill a balloon with water, tie off the top and lay it on a flat surface. It will be soft and jiggly which is what you want your breast to feel like after an augmentation. Now grab the balloon with both hands and circumferentially squeeze in on the balloon. Anyone touching it would say the balloon is now hard, but of course the balloon is not hard but your hands squeezing in (which represents a capsular contracture) are what is causing the balloon to feel hard.
Several excellent Board Certified plastic surgeons operate in Honolulu, Hawaii, and these surgeons can do several things during your breast augmentation surgery to decrease your chance of getting a capsular contracture.
The number one way to get a hard breast (capsular contracture) is to have blood around an implant, therefore the intra-operative techniques for decreasing the amount of blood around the implant are:
- Do the surgery endoscopically so that all bleeding vessels can be seen and electrically cauterized.
- During surgery, use one of several powders that can be sprayed in the implant pocket to decrease oozing from capillaries.
- Place a Jackson drain in the pocket attached to a bulb that is a closed system to remove that last little bit of blood around the implant. I normally leave this in for about 24 hours.
After the surgery, use an Ace wrap for several days that decreases the upward migration of the implant, but also causes increased pressure on the implant pocket which also decreases bleeding and oozing. Technically, this process of causing pressure is known as “tamponade”.
Finally, it is important not to overdo it for the first 72 hours after surgery. Each one of the excellent Board Certified plastic surgeons in Honolulu has his own post-op regiment after a breast augmentation. I personally have patients stay housebound but not bed-bound for the first 72 hours. They are not to wash dishes, make beds, or drive a car until the 4th day after surgery.
I am not a big fan of breast massaging and especially during that early 72 hours post surgery period. One can just imagine that breast massaging or implant displacement during that first 72 hours can’t help but increase oozing and some bleeding which definitely increases the chance of getting a capsular contracture, in my opinion.