The placement of breast implants (also called breast prostheses) involves a natural process called capsular contracture. Encapsulation is a normal phenomenon that occurs because a foreign object (the implants) has been placed in your body. Your body responds by creating a layer of connective tissue around the implant. This ensures that the implant becomes part of your body and cannot simply shift.

Excessive capsular formation and contraction

However, a small percentage of women with breast implants experience excessive capsular formation and capsular contraction. Your body creates that excess connective tissue around the implant, which can lead to pain and breast shape change. Your breasts may also feel harder and look less beautiful.

If you’re experiencing excessive capsular contracture, you may be eligible for treatment to remove the capsule. Another option is to have both the capsule and the breast implant removed.

Recognizing capsular contracture: the symptoms

There are varying degrees of capsular contracture. As mentioned, a capsule is always created after breast augmentation, and it is useful. However, when excessive capsularization occurs, it can result in symptoms of pain. According to the amount of capsularization done by the plastic surgeon based on a physical examination, there are four degrees of capsularization. Grade 1 is the normal capsule and grade 4 is the most advanced form of capsule formation.
At grade 1 the breast is soft and naturally shaped, at grade 2 the breast feels slightly firmer, at grade 3 the shape changes and at grade 4 the breast is hard and painful. Thus, there is always capsularization grade 1. Also, a breast may feel a bit firmer from the beginning and this is a normal situation after breast augmentation with implants. If over time the breast begins to feel increasingly firm and also changes shape, it may be that more caspase is forming than normal. This process does not always have to result in a grade 4 capsule, which usually requires another surgery. Insurers currently reimburse the removal of implants in cases of grade 4 capsular contracture.

Treatment for capsular formation

There are several ways to treat excessive capsular contracture:

• Splitting the breast capsule (capsulotomy).
• Removal of the breast capsule (capsulectomy).

The plastic surgeon should examine you first and then can advise on the best treatment for you. Often, complete removal of the capsule surrounding the breast implant (or capsulectomy) is the most appropriate treatment to prevent future recurrent formation of capsular contractures. This also involves placing a new implant.

Capsulotomy means just incising the capsule. In this case, the problem is more likely to reoccur.

Changing implants

You can choose, during the removal of the capsule, to immediately change the breast implants. The capsule is removed and your breasts look beautiful again. Of course, before surgery you will discuss this possibility and which implants (in terms of material, volume and shape) are suitable for you.

Removal of implants

When you have your breast implants removed without replacing them, more extensive surgery is often necessary. In fact, chances are that your skin is stretched and without implants you will be left with smaller and saggier breasts. A breast augmentation with your own fat is a possible alternative. Here, the plastic surgeon works with your own body fat to achieve an aesthetically pleasing result. This can be done in conjunction with a breast lift, for example.

Combination with insured care!

At MOOI Clinic, we offer you the unique opportunity to have your treatment qualify (in part) for reimbursed care. In some cases of capsular formation and capsular contracture your health insurer will (partially) cover the treatment. For example, removing the capsule and implants. Consult your health care policy on what the options are for this. You should then have a referral letter from the family doctor and the intake appointment will then take place at the hospital. Placement of new implants or breast augmentation with your own fat (lipofilling) and/or in combination with a breast lift is never covered by insured care.

The advantage at MOOI Clinic is that your plastic surgeon can perform both the insured and uninsured parts of the treatment at the same time.