The simplest way to explain a contracture is thickening of the natural “scar tissue” that forms around the implant. Our body’s natural reaction to a “foreign body” is to separate it from ourselves or make a “wall” around it. This is a normal process and occurs with joint implants, heart valves, etc. If the immune response continues and the thickness of the “scar” shell around the implant increases, it can become tighter. This can result in a change in the implant shape, position, and feel. This can also cause discomfort for some patients. The reasons that contractors occur are not entirely clear and this is an area of much research. Some of the theories involve bacteria, biofilms, contaminants, trauma, bleeding, leak, etc. Many measures have been taken to reduce the chance of contracture. These include changes in manufacturing of the implants, recommendations regarding antibiotics for irrigation, “no touch” techniques for implant placement, use of the Keller funnel, and protocols for prevention and treatment of contractures.
Dr. Short has a detailed and meticulous approach to preventing contractures and an established protocol for treatment. Although contracture formation is not common, it is important that the occurrence is addressed in a timely and efficient manner for best results.
Wrinkling actually can occur with almost all types of implants, but some implants are less likely to wrinkle as much as others. The most important factor in preventing the ability to see or feel wrinkling is “coverage” of the implant. Thus, the more breast tissue one has naturally, the less likely they will notice any wrinkling. Fat grafts or certain “materials” can be placed to provide more coverage for a person who has very little breast tissue. Placing the implants under the muscle also provides more “coverage”.
In general, higher profile, more cohesive gel, and appropriately sized implants are less likely to wrinkle than lower profile, less cohesive gel, oversized or incorrectly sized implants. Choosing the best implant for the size of the patients chest diameters and breast “pocket” dimensions is important in preventing wrinkling as well as rupture of the implant from folding flaws.
Implant rupture is very uncommon and is covered by most of the implant company’s basic warranties. Any defect of the implant will be covered by replacement of the implant and with the more recent extended warranties , patients can obtain inexpensive coverage for additional surgical costs associated with surgery in the case of contracture formation as well as an implant defect requiring replacement.