Capsular contracture is the most common complication with breast augmentation patients with between 5-10 percent of patients experiencing this complication at some point in time following their breast implant placement. When a breast implant is placed in the body, the body forms a lining around the implant as part of its natural healing process. We call this lining a "capsule." When the capsule lining around the breast implant tightens it causes the condition known as capsular contracture and subsequently causes the breast to become hard and constricts the implant causing the breast position to move higher on the chest.

The exact cause of capsular contracture is unclear, although inflammation following surgery - either from bacterial contamination or bleeding around the implant - is thought to be the most likely cause. Unfortunately, there is no way to know in advance who might get a contracture, and presumably there is the possibility of genetic differences that come into play. Some surgeons believe that using implants that are too large or are poorly fitting may also be a cause.

While capsular contracture cannot be completely prevented, Denver plastic surgeon Dr. Nick Slenkovich has carefully developed his own steps to decrease the chance of capsular contracture in breast augmentation patients before, during and after surgery. These steps are devised to provide patients with the highest quality care and the safest breast augmentation surgery possible.

Before Breast Augmentation Surgery:

• Proper breast implant size – Dr. Slenkovich works with each breast augmentation patient to determine the appropriate size of breast implants based on their characteristics of their individual anatomy. During the consultation he carefully measures the patient's breast width to determine an implant size that will best achieve her breast enhancement goals, while decreasing the chance of capsular contracture with a well fitted breast implant size and profile.
• Avoiding aspirin, fish oil and other herbal medications – In the week prior to a breast augmentation patients are advised to avoid taking aspirin, fish oil and other medications and supplements that are known to contribute to bleeding.
• Hibicleans antibacterial soap – The morning of their surgery, breast augmentation patients are asked to shower and wash their torso and underarm area with hibicleans, a surgical grade anti-bacterial soap, that is provided during the pre-operative appointment.

During Breast Augmentation Surgery:

• Limiting the traffic in and out of the operating room during the surgery ensures a sterile environment for breast implants.
• Observing surgery center protocols - The state licensed, AAAASF certified surgery center complies with the most rigorous safety, sterilization, filtration and ventilation standards in the healthcare industry.
• Strict sterile operative protocols are used and emphasized at all times by all members of the operating room staff. These protocols include using an additional layer of adhesive drapes to "seal off" the operative field. Dr. Slenkovich has performed  hundreds of cases with the same operating room staff, who maintain protocols for strict sterile techniques.
• Limiting breast implants exposure to the environment before the implants are inserted into the patient's body further decreases the chance of infection or contamination of the implants. Each breast implant is prepackaged in twice sealed sterile packaging by the implant manufacturer. The outer wrapping, which may house foreign particles, is removed before the breast implant package is brought into the operating room. Just prior to placement, the second layer of packaging is removed from the breast implants. Dr. Slenkovich is the only person to handle the breast implant to further limit the chance of contamination.
• Observing a glove change protocol further reduces the chance of contamination on the breast implants.
• A triple antibiotic wash solution is used to re-clean the breast area just prior to placement of the breast implants into the newly created breast pockets and the exposed area of the chest is surgically prepped one more time with antibacterial surgical prep solution.
• Meticulous control of bleeding during surgery reduces unnecessary blood retention in the breast implant pocket. Dr. Slenkovich is meticulously strives to have each breast implant pocket dry of bleeders before placing an implant.
• Placing the breast implant under the pectoralis muscle is thought to reduce the chance of capsular contracture by half, and is Dr. Slenkovich's preferred placement option for breast implants rather than over the muscle.
• Antibacterial "Steri-strips" on incisions - After surgery, the surgical staff places steri-strips over the incision site to prevent infection at the site, which can increase the risk of bacterial contamination around the implant.

After Breast Augmentation Surgery:

• Limiting strenuous activity and heavy lifting is advised for a minimum of two weeks to decrease possibility of causing bleeding near the implant and the chance of capsular contracture.
• Peri-operative touch therapy is recommended for breast augmentation patients to stimulate the lymphatic system circulating lymphatic fluid, promoting healing and preventing swelling and bruising. 
• Light-touch breast massage techniques are recommended to further prevent capsular contracture.
• Taking oral antibiotics after surgery. Antibiotics are given to each breast augmentation patient to take after surgery to prevent infection at the incision site.

Choosing to undergo a breast augmentation is an exciting decision for any woman to make. By taking these extra steps to prevent capsular contractor, Dr. Slenkovich strives to insure you have a safe surgical experience while minimizing the chances for complications so that you can fee confident in your decision.