Capsular Contracture Atlanta

Capsular Contracture & Breast Implant

Scar tissue forms around all implanted materials in our bodies, as a natural part of healing, but scar tissue becomes troublesome when it tightens. Capsular contracture can occur after a Breast Augmentation with implants and causes the breast to feel firm, unnatural and often painful. The most severe cases are often referred to as “coconut breasts.” Capsular contracture can occur anytime but tends to do so in waves called either “early” or “late” capsular contracture.

Capsular Contracture Classification

Correcting capsular contracture involves several factors including: the extent of the damage, how soon it occurred after implant placement, lifestyle, patient history and expectations. The most common classification system used by Board Certified Plastic Surgeons is the Baker Classification;

  • Baker I describes a breast that is soft and feels and looks normal.
  • Baker II involves a breast that is slightly firm, often feeling. different from the opposite breast, but with no visible changes.
  • Baker III capsular contracture is significantly firm, with visible changes meaning a visible change in shape or contour.
  • Baker IV …the breast is very firm to hard, easily palpable implant, significant visible appearance, may feel cooler to the patient, and is painful with normal activity and mild palpitation.

Capsular Contracture Consultation

Dr. Rudderman believes the consultation is critical for you and him. The consultation includes the following: full evaluation of your original surgical experience including implant type and location, placement and technique used. This information can yield insight into the contributing factors to the capsular contracture. All of your questions will be answered and your concerns addressed. Dr. Rudderman has done hundreds of breast surgeries and can project your likely outcomes. This is done in an embracing, relaxing environment. From the consultation evolves…trust, respect, mutual understanding and a personalized treatment plan.

After your first consultation with Dr. Rudderman, you will realize that there truly is a difference in how surgeons approach their profession. For Dr. Rudderman…that difference means understanding your desires & goals & providing a level of service that places safety & comfort alongside predictable & pleasing outcomes.

Capsular Contracture Factors

There are two categories of capsular contractures:

  1. Early capsular contracture occurs within weeks to months following implant surgery.
  2. Late capsular contracture occurs years after surgery.

The general thinking is that the inflammation that occurs in the breast implant area may influence the capsular contracture. Conditions that cause the inflammation include: hematoma (blood collection) in the pocket during surgery, seroma (fluid collection) around the implant following surgery, bacterial contamination during implant placement, and factors such as smoking and tobacco use that affect blood supply and healing. Late contractures may be related to a gradual reaction to the silicone shell or gel compounds.

Research has shown that placement of breast implants under the pectoral muscle results in fewer cases of capsular contracture. Dr. Rudderman can give you further information on this.

Dr. Rudderman uses an implant placement technique that is technically specific, respectful to the tissues & provides a precise implant pocket without trauma to those tissues. There is less swelling, less pain & little to no bruising…healing is faster.

Capsular Contracture Procedures

Treatment outcomes for capsular contracture of the breast are not predictable and recurrence is common. However, with well-planned, individualized treatments, it is often possible to achieve results that dramatically improve the situation.


Research shows that certain nutritionals, especially those with anti inflammatory effects, may reduce initial and recurrent risk of capsular contracture.

Asthma Drugs

Called leukotriene inhibitors affect the bodies’ response to inflammatory stimuli and may be useful in some cases of capsular contracture. There are side effects and most surgeons do not recommend this course of treatment.

Closed Capsulotomy

Involves an outdated procedure of “squeezing” the breast to release the capsule. This is painful and is not recommended as treatment for capsular contraction. Dr. Rudderman does not use this technique on any patient. Seek a second opinion if this is recommended to you by any surgeon.

Surgical Procedures for Capsular Contracture

Open Capsulotomy

Describes a surgery that opens and releases the capsule using an electro cautery. This procedure allows for the capsule to expand, resulting in a softer breast and more room for the breast implant. If the implant is in good condition, is placed above the muscle and is not leaky, this may be a good option.


Is surgery used to remove the entire capsular lining around the implant. This is performed for the following: the capsule is thickened, a history of previous infection exists, there was earlier trauma, if the implant is silicone gel and is ruptured, if the capsule has calcification plaques from older implant versions, and when removal of the capsule is required to restore a more normal breast shape. This surgery can be done enbloc meaning a larger incision is used and the capsule is not opened so the implant is removed with capsule intact. IN these cases a new implant is needed.

Replacing a breast implant may yield a better long-term result, especially if your current implants are from a previous “generation.”

Acellular Dermal Matrix for Capsular Contracture

Used daily in surgical/neurosurgical procedures around the world, Acellular Dermal Matrix (ADM) is a material derived from humans and animals and is used as transplant material in humans. New data shows that use of ADM may reduce rates of capsular contracture.

There are several options, as you can see. The information can be confusing and frustrating. Some women who come to me for treatment have gone through significant lifestyle changes, pregnancies, weight shifts, and aging with hormonal changes…all of which has affected their breast volume. Their goals have changed over time and they just want a healthy, natural looking appearance. That’s what I do during the detailed consultation. There are options today that match nearly every goal to achieve a beautiful, natural appearance.

  • Dr. Rudderman and his staff made the experience easy and comfortable. They were realistic communicating surgery expectations, expected pain levels and down time from work. Nurses were informative and friendly and wait times minimal. I also liked the fact that Dr. Rudderman does all his own work and doesn't let other less experienced people do parts of the surgery the way other doctors may. I'm only one week out of the surgery, but I am very satisfied with the results so far.

    Susan Parker | Atlanta, GA


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Dr. Rudderman’s unique, integrated approach to plastic surgery employs only safe, effective, predictable surgical techniques that are driven by uncompromising respect for the natural condition of the human form. He understands that the body changes with time – as do desires. His primary goal is to deliver the best possible plastic surgery … specifically matched to each patient…in a safe environment with ultimate respect for every single individual…their concerns and goals. LEARN MORE »

“The best plastic surgery results must give each individual the opportunity to feel comfortable now and in the future…”

Dr. Randy Rudderman


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