Amelioration of capsular contracture by motion restriction.

Surgical augmentation of the female breast has become a well-accepted and frequently performed operation since the introduction of the Cronin Silastic mammary prosthesis in 1963. A sleeve of scar tissue (collagenous capsule) consistently develops around every silicone implant. This "reactive bursa" is the normal healing response to this unique foreign body, and should not be referred to as a complication. It actually supports the prosthesis and contours the augmented breast. Operative technique includes precautions to prevent particulate or microbial contamination. Postoperative management involves restriction of motion of and around the mammary implant. (I realize this is a departure from currently accepted techniques. The methods presented, however, are based on physiologic principles of wound healing.) The results for all (private practice) patients who underwent augmentation mammaplasty during the four-year period of 1980 through 1983 were evaluated and codified. They suggest that the incidence of capsular contracture of the augmented breast can be decreased by taking precautions to ameliorate the foreign body reaction to silicone.