3 Exercises to Prevent Capsular Contracture

Updated March 2024

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The most popular plastic surgery has historically been breast augmentation. This procedure may be very appealing as it increases the size and fullness of breasts. While this can be satisfying, additional surgeries are frequently required to resolve issues. Capsular contraction is the most common issue. 

Read below to learn more about capsular contracture and possible ways to help with prevention, as well as other useful information.

What is Capsular Contracture?

Capsular contracture is a response of the immune system when unknown matter enters our bodies. This can occur in multiple situations which involve pacemakers, prosthetics, as well as other surgical-type of procedures. 

However, this is most commonly discovered as a result of the leading complication, which is breast augmentation surgery involving breast implants. This is typically seen after collagen fibers form and become capsules that shrink, tighten, and compress. 

As a highly painful result of medical complications, this can also distort the presentation of the breast implant and the overall appearance of the chest. Currently, the specific cause of this is not fully recognized and can lead to ruptures, bacteria overflow, leakage, and hematoma. This is the body’s immune system kicking into defensive mode to increase protection to avoid further damage.

There are several grades of capsular contracture based on the Baker scale. This is the most widely-used method of determining the firmness of the breast after surgery. It was not intended to describe prosthetic breast reconstruction specifically, so the dimensions were modified to incorporate additional classes to better classify capsular contracture. The classes include IA, IB, II, III, and IV. 

For this assessment, IA would be categorized where the breast is soft and appears normal in shape, while class IB indicates a visible yet soft implant. Class II corresponds to an implant with mild firmness with a somewhat normal appearance. Class III indicates a moderate firmness with an abnormal appearance which could still lead to a good outcome. Class IV usually is indicative of a hard, painful, and symptomatic breast, which would result in a very poor appearance and be considered a bad outcome. 

Many different approaches to surgery have been proven to reduce capsular contracture. Submuscular breast implant placement uses textured or polyurethane-coated implants. Additionally, board certified plastic surgeons try to limit the handling of the implants and minimize contact with the skin of the chest before any insertions. Although some situations may require a breast implant, it is always best to research and determine the best approach to avoid capsular contracture. 

 What Can I Do to Prevent Capsular Contracture?

There are a few precautions that can be taken to help in preventing capsular contracture. In addition to a good exercise regimen, different movements can be performed to help increase blood flow to the chest wall and the breast capsule. Some of these are part of a group of breast implant exercises. 

Patients who engaged in breast augmentation exercises reported improvement in scar quality after one year. These activities were shown to not increase complication or reoperation rates or cause a reduction in scar quality after one year. Dealing with some of the aesthetic challenges which result from capsular contracture is something else that needs to be considered before pursuing this type of surgery.

Walking

After breast augmentation surgery, patients can start engaging in a light walking regimen. Initially, it is advisable to start with some short walks around your home every few hours. Movement is very good for circulation and helps in the prevention of blood clots. After a few weeks, patients can slowly increase the intensity of the cardio by walking uphill or even on a treadmill. 

As long as the comfort level continues to increase, after a month, patients can start to resume other exercises – without heavy lifting. Finally, after the six-week mark, patients are generally completely healed and can resume a normal exercise routine. It is important to practice caution to avoid straining any of the sensitive areas or worsening some of the existing scar tissue. 

Upward Breast Implant Exercise

By cupping the breast with your opposite hand, feel for and push the implant upward. Be careful not to overload the full breast, and just focus on the implant itself in an upward direction. Move the top of your hand in toward the chest wall to ensure thorough and efficient movement. 

Cleavage Manipulation

While cupping your outer breast with your opposite hand, put your hand on the implant in the middle portion. In this process, you can manipulate both breasts by hugging yourself. If there is no uniformity and the breasts aren’t perfectly symmetrical, don’t worry, as chest muscles vary in patients. 

This can affect the presentation of the cleavage, which prevents the breasts from meeting perfectly in the middle. The key to this exercise is to increase the blood flow to the area.

What Increases the Risk of Capsular Contracture?

Risk factors can be increased due to a longer duration of follow-ups, breast reconstructive surgery in patients with a history of breast cancer, sub-glandular implant placement, postoperative hematoma, and a textured implant surface. Some of these issues can be genetic and more difficult to avoid. At this point, there isn’t a significant amount of evidence supporting other factors which cause capsular contracture. 

Final Thoughts

Capsular contracture is a challenging issue that cannot usually be resolved using methods other than capsulotomy or capsulectomy with implant removal or a change in the plane of insertion. For over forty years, implants have been utilized for both breast augmentation and reconstruction. 

Capsular contracture is the most distressing complication, which can bring on a lot of additional pain – and stress. The incidence of this occurrence ranges from .5% to 30% and depends on the coating and type of implant, the plane of insertion, and the surgical protocol. There are also a lot of extrinsic factors that affect the incidence. 

Breast implants bring a lot of other potential issues which can lead to deformities. One example of this is known as a double bubble, which happens when implants sag beneath the bottom of the breasts. Unfortunately, this presentation can be very distorted and can be caused by submuscular placement, poor positioning of implants, or even constricted breast creases.

Women most commonly undergo breast augmentation because of the desire to change the size of their current breasts. It is very important to work with a board-certified plastic surgeon to ensure the best implant is utilized based on your body type. The FDA continues to publish details on breast implants based on their extensive research studies. The FDA also recommends that patients with implants continue to get regular screenings to detect ruptures or other imperfections that may lead to further issues.

Breast implants are not constructed to last a lifetime, and there is a good probability of additional surgeries to resolve issues that arise as a result of them. Implants are also made of different materials, as silicone is different from injectable silicone. Not all types are FDA-approved for breast augmentation, reconstruction, or body contouring. 

There are reports of other symptoms from implants, which include joint pain, muscle aches, confusion, chronic fatigue, autoimmune diseases, and others. There is currently insufficient evidence to support an association between breast implants and these diagnoses; however, it is important to closely monitor as these may appear suddenly. It is extremely important to follow all of the instructions and communicate as much as possible with your surgeon. Over time, other tests may be performed to proactively avoid additional complications.

Frequently Asked Questions

How do I massage my breasts to prevent capsular contracture?

The aforementioned exercises can also be utilized in massage to help reverse some of the hardenings. It can be helpful to massage up to three times per day in the first month post-surgery, twice a day in the second month, and once a day past that, if possible. 

This will help with blood flow, especially as scar tissue forms. It is important to keep in mind that, at this time, based on the National Institutes of Health, the available data do not support breast massage to prevent capsular contracture.

Can vitamin E reverse capsular contracture?

Vitamin E for capsular contracture is a low-cost, safe, and effective method to reduce the number of postoperative capsular contractures after augmentation of the breast. In a synthetic form, vitamin E (alpha-tocopherol) can help in the reduction of nausea or skin eruptions. These are frequent in patients with oily skin. To date, there have been no harmful side effects reported with the use of Vitamin E. It does not affect coagulation systems and does not cause excessive bleeding during or after surgery. The recommended dose is 1000 IU, b.i.d. for two years beginning one week before surgery.

Additionally, vitamin E can help with the appearance of scars and scar tissue. There are a plethora of vitamin E products, types, and brands on the market. It is important to do research and work closely with your team of medical professionals to utilize the most optimal product for your needs.

Can exercise help capsular contracture?

Natural healing processes can help with capsular contracture. Scientific journals published studies that focused on patients who underwent breast augmentation mammoplasty with implant placement. These individuals performed breast exercises to prevent breast contracture. In many cases, although performing certain exercises may not directly contribute to capsular contracture, there are still mental health benefits. 

What happens if you don't massage your implants?

Based on patient studies, breast massage techniques were not found to prevent capsular contracture. There should be more studies involving standardized techniques to better assess the efficacy of breast massage in preventing capsular contracture. At this point, breast massage techniques are still considered controversial based on the amount of existing research.

This article has been reviewed by our editorial board and has been approved for publication in accordance with our editorial policy.