The following interview focuses on questions related to breast augmentation and a post-surgery condition called capsule contracture specifically. Dr. Widder’s shares his experience and insights with women who are considering plastic surgery for the first time or are looking to explore a higher level of care and quality results. Subscribe to our blog for weekly insights and feel free to suggest topics or questions you would like answered.
Q: How often are your breast surgeries purely cosmetic and how often are they done for medical reasons?
I don’t usually do reconstructive surgery. I mainly do cosmetic surgery. There is sometimes a reconstruction aspect of cosmetic surgery. When you have a capsule contracture that occurs from a cosmetic surgery, you have to fix it.
Q: What is capsule contracture?
When we put any foreign body into our bodies, the tissue around it will encapsulate it – that is, it will surround it with scar tissue. This is a protective mechanism of the body and it’s normal. After surgery, this is expected, but what you want to have is a soft capsule. A soft capsule allows the implant to move within it and it gives the appearance and the feel of a natural breast. Once in a while, a patient will develop hardening of the breast, or capsule contracture. Most of us have seen people with a burn on the arm or the neck where the scar has contracted noticeably in one direction. The same thing can happen with the breast. It’s very devastating to the patient – they are expecting to have natural looking breasts and instead they get two hardballs or two apples sitting on their chest. It’s very disappointing. So in this case, some breast reconstruction is the remedy.
Q: What do you do to repair capsule contracture?
The way to relieve it if the contracture is not very severe is to do a capsulotomy. This is a surgery during which I cut the scar tissue in multiple directions to enlarge the space and reduce the tightness or the tension. After surgery, the patient is instructed to do massage – to move the implant in different directions so it maintains a relaxed position in the capsule. Without the massage, the scar, by its nature, will contract.
But in the condition where there is biofilm – bacteria embedded in the scar tissue and also on the implant – to get a nice, natural looking breast, you have to remove the implant and the scar tissue. You literally have to shell or scoop out the whole area, which is a difficult and tedious procedure. This procedure takes a long time, but it is the best technique to recreate a natural looking breast and avoid the recurrence of capsule contracture. If you were to just do a capsulotomy and leave the implant in place, it is almost guaranteed that the condition will recur. The way to avoid that is to do the capsulotomy and replace the implant.
Q: What are some of the causes of capsule contracture?
Probably the most common is not doing the massage. But a few patients will have some bleeding or some develop an infection. I always tell my patients that whenever they have any dental procedure to take antibiotics because bacteria from the mouth can enter the bloodstream, seed on the implant, and start the process of capsule contracture. Also if the patient is having any gastrointestinal procedure like an endoscopy or colonoscopy, they also have to take antibiotics. That’s part of my discussion with my patients in the beginning so they know what to do in the future to avoid complications.
Q: What made you choose to focus your practice mainly on cosmetic surgery over reconstructive surgery?
Those choices go with one’s personality. I love surgery and I love medicine and everyone has their own strengths and limitations. I decided a long time ago to be a happy surgeon and deal with happy situations. I enjoy giving people the bodies that make them feel great about themselves and boost their confidence and self esteem.
To find out more about the Widder Cosmetic & Plastic Surgery Center stop by during office hours: 9 – 5pm, Mon – Fri, or contact us today! Office Phone: 703.506.0300.