TREATMENTS

NON SURGICAL

Breast massages are an exercise usually recommended after breast augmentation. If there is hardening of the breast, aggressive massaging can prevent worsening capsular contracture. In some cases, aggressive massaging can reverse some of the contracture. The theory is that forcible movement of the implant prevents the developing capsule from tightening around the implant. 

 

Many studies have been conducted on breast massages. Some show a benefit in preventing capsular contracture.

BREAST MASSAGES
Overall, it is probably worthwhile to begin a regimen of aggressive breast massages if capsular contracture is suspected. The reason is that there is very little, if any, downside to performing the massages. It can stop or reverse the hardening of the breast in some cases. Therefore, most surgeons would agree it is worth doing. 

There is a class of medications which show some benefit in improving capsular contracture. This class of drugs is called a leukotriene antagonist. They include montelukast (Singulair) and zafirlukast (Accolate).

 

These medications were developed for the treatment of asthma. Doctors discovered that women taking these medications, who had previous breast augmentation and capsular contracture, had softening of their breasts after starting treatment. 

 

MEDICATIONS

Using these medications for capsular contracture is considered an "Off Label" use. As with all drugs, there may be side effects. In particular, women with liver disease should not take these medications. 

 

As always, a thorough consultation with your doctor should be completed before taking any prescribed medications.

CLOSED CAPSULOTOMY

"Capsulotomy" means opening ("otomy") of the capsule. A closed capsulotomy is a maneuver done to "open" the capsule without surgery. It is acccomplished by applying a very strong squeezing force to the breast, usually with the hands. If the maneuver works, a loud "crack" can be heard and/or felt signifiying that the capsule has been broken open. The breast may immediately feel soft. 

 

This maneuever is very painful for the patient. In addition, closed capsulotomy is associated with many complications such as bleeding, implant rupture and incomplete opening of the capsule. The bleeding, in some cases, can be severe and can require urgent surgery to stop. 

 

For these reasons, closed capsulotomy is no longer recommended as a treatment for capsular contracture.