Hi. I had a skin sparing mastectomy with implant about 4 years ago, and was really happy with the outcome. Because no skin was removed I had a normal implant, not an expander. Once everything settled down, it looked really good, and I was totally happy.
I then had 25 rads sessions, all was still ok.
Earlier last year I started to get some pain when sleeping on a certain side at night, like the implant had stuck to my chest wall, and a ripping feeling when I moved. Also the implant looked smaller, and harder, and then I noticed it had changed shape, as I could see the scar when standing head-on looking in the mirror, which I couldn’t do before.
I went in to see my surgeon, she confirmd the implant had ‘casulated’ due to the rads, which was a known risk, but I never asked what that actually meant. Can anyone explain??
Thanks!
Good old google. This is what I found for you.
Capsular Contracture Overview
What is capsular contracture?
When breast implants, or any other foreign object, are placed in the body, the body forms a lining around it. This lining, or capsule, is formed by your own living tissue. Many people refer to this lining as the “capsule”, “tissue capsule”, or “scar capsule”, although it is not exactly the same thing as scar tissue. This is the body’s natural response to a foreign object.
Capsule contracture, the most common complication of breast augmentation surgery, can happen at any time, but seems to be more common in the first several months after surgery. At the time of the initial surgery, a pocket is made for the implant. During the healing process, a capsule forms, which is comprised of fibrous tissue. The body is genetically programmed to shrink scar tissue somewhat. Under normal conditions, the pocket remains open, thus allowing the implant to look and feel natural. However, in some people, the capsule will tighten, and squeeze the implant. This makes the breast implant feel hard, and distorts the appearance of the breast. In the later stages, the implant feels very firm, and may take on a “ball-like” look. It is important to remember that it is not the implant that has hardened. The shrinking of the capsule compresses the implant, causing it to feel firm/hard. However, once the implant is removed, it is just as soft as it was the day it was inserted.
What causes capsular contracture?
Currently, the causes for capsule contracture are still very unclear. The following are thought to put you at greater risk for developing capsule contracture:
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Transient germ contamination. Germ contamination and/or long-term bacterial contamination of the implant shell can cause an inflammatory reaction, thus leading to the shrinking of the capsule.
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Subglandular placement. Breast implants placed above the muscle tend to have higher capsular contracture rates, versus breast implants placed in behind the muscle, also known as submuscular placement.
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Infection. Capsule contracture seems to be more likely following an infection.
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Seroma. If you have had seroma, you may be at more risk for capsular contracture.
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Hematoma. Hematomas can cause an inflammatory reaction, which can lead to capsule contracture.
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Smoking. Smoking decreases the oxygen levels in the blood, which could result in delayed healing, and possibly an inflammatory reaction.
Hi
The way it was explained to me: The tissue round the implant naturally forms a seal. Rads cause this to tighten and shrink and form scar tissue. This makes the implant feel hard (the silicon itself doesn’t harden - it’s just squished in). It can also cause pain and the breast to distort.
I had an LD flap + implant recon and have had to have rads. My PS says that if I get bad capsulation he can operate to remove the scarred/tight ‘skin’ round the implant. Don’t know if this is possible with an implant only recon.
HTH
Dx
Another thing;
Have you checked with your surgeon who manufactured your implants? If it is PIP, I would get it removed rather quickly as it seems already damaged.
I’m still waiting for the NHS to make an announcement re PIP’s implants, and I guess that I am not alone either!
Mazzalou,
I am sure this is added stress you could do without.
I don’t know quite know why but I did consider reconstruction but I would not have implants. Still never had the guts to go throug recon.
I believe that the PIP implants have been banned in this country for the past 18 months. I know I haven’t got one 
OK, thanks, that helped explain things!
On the PIP implants, I did read that 95% were used by private clinics, so any of us recon ladies I think the chances are very small that we’d have them, but I will ask to be on the safe side.
I have been offered a procedure to do ‘liposuction’ on my belly (plenty to spare there!!) and this will then be injected back in around the implant to try to soften/cushion it.
I had wondered why they didn’t just replace the implant, but the details above confirm why, that makes complete sense now.
If all else fails, they said I can have the implant out and a diep/tram or LD flap recon, but to be honest, I don’t want any more major surgery. I’ll report back if anyone is interested in the outcome, surgery is booked for the 9th.
My Surgeon told me they never used the PIP implants in our Health Trust and most used in the UK were for cosmetic surgery. DJ’s right, as they were banned 18 months ago, so any op after that means you’re safe!
Quick question for anyone who’s had implants - I’ve had two mastectomies, one for BC (2010), one preventative. I had the preventative one, with an expander implant in October, at the same time the expander implant on the BC side was removed and replaced with a silicon one. I am very prone to scar tissue according to Surgeon, so capsular contraction is where my implants tend to go (!). I have pain in my back this time though - both sides on and off, sort of shoulder blade level. Has anyone else had this? I don’t remember it from first time round. Also the scars on both sides are very tender to touch. Be curious to hear if anyone’s continued to feel pain a few months after op. Thanks!
Hi Julie, I didn’t have back pain, but the scar was sometimes very tender for a good few months. Sorry can’t be more help really…
I went for my pre-op today, and asked if my implant was a PIP one, as it was done originally in 2008, they didn’t know but were going to check and let me know.
Surgery all set to go ahead on 9th, apparently I should be back home the same day and recovery is pretty quick as there is nothing invasive really.
Fingers crossed!
Thanks CrazyDancer. My scar’s tender too, so it’s reassuring to hear yours was too. So hard not to be paranoid! Good look on the 9th. Will be thinking of you.