Capsular contracture can occur in patients who have breast implants. While there can be many reasons to have capsular contracture, I find that the more common reasons tend to be:
- history of hematoma or undetectable hematoma
- history of previous infection or subclinical infection
- long duration of implant placement
- patient specific factors (i.e. prone to keloid, hypertrophic scar, capsular contracture, etc.)
In patients who have a history of recurrent capsular contracture, despite previous capsulectomy, I have added to my management plan the following: At the time of capsule surgery, the implant is removed and the implant pocket is cultured. Post-operatively, the patient is placed on Keflex if able to tolerate, or clindamycin if there is a cephalosporin allergy. If the culture result is a bacterium not sensitive to Keflex or Clindamycin, then an antibiotic is chosen to fit the appropriate bacteria.
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