Capsular contracture is a complication of breast implant surgery where the body forms a fibrous scar tissue capsule around the implant. While this capsule develops around every implant, it can sometimes thicken and tighten. This leads to firmness, pain, and changes in the breast shape. The tightened tissue compresses the implant, causing the breast to feel hard. Home management is typically reserved for less severe presentations, focusing on non-surgical methods to maintain tissue softness.
Assessing Severity for Home Management
Self-management is only appropriate for the earliest stages of capsular contracture, requiring a proper assessment of severity before treatment begins. The most common grading system is the Baker scale, which classifies contracture into four grades based on feel and appearance. Grade I is the mildest form, where the breast remains soft and appears natural.
Progression to Grade II means the breast feels slightly firm to the touch, but the appearance remains normal. These first two grades are suitable for conservative, at-home management strategies like massage and supplements. If the condition progresses to Grade III, the breast becomes noticeably firm and the shape may appear distorted. Grade IV is the most severe, characterized by a breast that is hard, painful, and clearly misshapen. Contracture reaching Grade III or IV severity requires prompt consultation with a specialist for medical intervention.
Specific Massage Techniques and Physical Therapy
Physical manipulation of the implant and surrounding tissue is a primary component of at-home management for mild capsular contracture. These exercises, often called implant displacement maneuvers, work to stretch the internal pocket of scar tissue. This prevents the tissue from adhering tightly to the implant shell, encouraging the capsule to remain flexible and allowing the implant to move freely.
One technique involves using the hands to push the implant in various directions: up, down, inward toward the chest wall, and outward. For example, one movement requires placing the hands on the outside of the breast and pushing inward with deep, consistent pressure to displace the implants toward the center. Another involves placing the hands above the nipple and pushing down firmly to move the implant lower on the chest.
These displacement exercises should be performed consistently throughout the day, often recommended for two to five minutes per breast, twice daily. Apply steady and firm, yet gentle, pressure to ensure the implant itself is being displaced, not just the overlying skin. Avoid using excessive or sharp force, as overly aggressive manipulation can potentially damage the implant shell or surrounding tissue.
Supplements and Medications Used Orally
Beyond physical therapy, certain oral medications and supplements are sometimes used to manage or prevent the progression of capsular contracture. These treatments aim to modify the underlying inflammatory response that causes the scar tissue to thicken. Any medication regimen must be discussed with and prescribed by a healthcare professional.
Vitamin E is a common over-the-counter supplement recommended for its antioxidant properties, which may help moderate the inflammatory process. While some patients use it as an adjunct therapy, scientific evidence supporting its effectiveness as a primary treatment for established contracture is limited. Dosage recommendations typically involve high-dose oral supplementation.
Prescription leukotriene inhibitors, such as Zafirlukast (Accolate) and Montelukast (Singulair), are often prescribed off-label for treatment. These medications are primarily approved for treating asthma, but they function by blocking leukotrienes. Leukotrienes are inflammatory compounds involved in the body’s immune response. By dampening this response, the drugs aim to prevent the excessive formation or tightening of the fibrous capsule.
The standard regimen for Zafirlukast often involves taking a 20 mg dose twice daily for up to six months. These medications treat early-stage contractures and are not a substitute for surgery once the contracture is severe. Because these are prescription-strength drugs that can interact with other medications and have side effects, close medical supervision is necessary.
When to Stop Home Treatment and See a Specialist
Understanding when to transition from home care to professional medical treatment is paramount for safety and effectiveness. If, after a dedicated period of consistent massage and supplement use, the breast continues to harden or symptoms worsen, the contracture has advanced beyond conservative management. Increased or new pain not relieved by over-the-counter medication is a significant warning sign of progression.
Indications to stop home treatment include visible distortion of the breast shape, a noticeable change in implant position, or the breast becoming progressively harder. These changes suggest the contracture has likely reached Baker Grade III or IV. At this stage, the capsule is too tight and thick to be stretched or softened by massage or medication alone. A specialist can then evaluate the condition and discuss professional interventions. These options typically involve surgical procedures like a capsulotomy, which strategically scores the capsule to release tension, or a capsulectomy, which involves complete removal of the hardened scar tissue.