Encapsulation of a breast implant that results in capsular contracture is the most common complication after breast enlargement. It is difficult to determine the exact incidence of capsular contractures because different variables have been shown to affect the manifestation of the problem. For example, there are saline implants and there are silicone implants. It is universally accepted that silicone implants lead to a higher chance of capsular contracture, although this is changing due to newer implants that have a better shell and less potential for silicone tissue reaction. Also, the shell of the implant can cause variations in the incidence of capsule contracture. The implant shell is essentially the implant bag, which can be textured or smooth. It is well accepted that the incidence of capsule contracture for textured implants is much less when they are placed over the muscle, but when placed under the muscle both types have similar incidences of capsule contracture. The placement of the implant also affects the incidence of capsular contracture; it is generally accepted that if the implant is placed under the muscle, there is less chance of developing a capsular contracture.
To be on the conservative side, and assuming any given surgeon is using a specific set of implants, the incidence of capsular contracture can vary around 10% at 10 years. These are the capsular contractures that will require a revision of surgery. In other words, the incidence can be much higher, but the other capsule contractures do not cause significant distortion, pain, or patient dissatisfaction that will require surgical intervention. The incidence is most likely related to a combination of the local breast and the patient’s variables combined with the different types of implants that are used to augment the breast. This is obvious due to the fact that capsular contracture is more common in both breasts than on just one side. One piece of good news is that there does not appear to be any immune response of the body that results in a capsular contracture.
Unfortunately, for me to provide you an exact incidence of capsular contracture will depend on how the scientific study was made, what type of implant was used, the time since the surgery, the grading system etc. All these different shortcomings have resulted in averages of capsular contracture that can go as high as 80%, but as I mentioned before, in most surgeons’ practices, the ballpark number is that 10% of patients will experience symptomatic capsular contracture that requires surgical intervention.