Introduction Buttock augmentation with implants is a major plastic surgery procedure, and no matter how skilled and experienced your plastic surgeon is, problems can still arise during or after the procedure. The likelihood of complications after surgery is rooted in the fact that every person has a different body and different healing pattern. The natural arrangement of connective tissue differs from patient to patient. As such, each patient’s incisions heal differently. One of the rare but serious complications that may occur after buttock implant surgery is capsular contracture. Some patients develop thick scars after the procedure, whereas others get little and less visible scars. In some cases, the scar tissue may continuously tighten around the implant and create physical pain for the patient, besides affect the butt shape. This condition is called capsular contracture. How capsular contracture happens Complications after buttock implant surgery are rare, thanks to the advancements made in the field of plastic surgery. However, this doesn’t mean that butt implant surgery is free of risks and complications. The risk of capsular contracture after butt implant surgery cannot be entirely ruled out. The leading causes for the development of capsular contracture include genetic factors, surgical error, the use of overly large implants, placing of the implants over the gluteal muscle, seroma and hematoma, infection, and carelessness on the part of the patient. During the pre-operative consultation, you should ask the plastic surgeon as to how likely it is for you to get capsular contracture after butt implant surgery. The plastic surgeon may advise you to avoid getting implants if you are prone to the development of capsular contracture, or the surgeon may come up with specialized surgical techniques that can reduce the risk of capsular contracture. Buttock implant surgery involves incisions. Implants come in different sizes, and the size of the implant determines the incision technique. The implants are placed inside the butt through the incisions, and the incisions are sutured and closed. The incisions will then gradually change into scars in the weeks and months following the operation. Scarring occurs because your body acts to seal the incisions by increasing collagen production. In most cases, the scars develop normally and fade over time. However, in rare cases, the scarring may occur abnormally, leading to capsular contracture whereby the scar tissue continuously contracts and squeezes the implants. The condition creates physical pain for the patient and even changes the shape of the buttocks. When capsular contracture happens, the capsule of the scar tissue tends to become remarkably hard and tightens around the implant. According to one study, one in ten butt implant surgery patients experience some degree of capsular contracture. The condition can happen at different levels. A severe form of capsular contracture not only triggers chronic pain in the butt but also make the butt look abnormally shaped. Capsular contracture happens typically during the recovery process. In most cases, the condition affects the patient within the first two years following the operation. In some cases, it can even happen many years following the surgery. The exact cause of capsular contracture differs from one patient to another. However, it is a known fact that capsular contracture does not occur in any way due to issues with the implants, except for selecting the wrong implant size and having the implant in the wrong place. Studies show that genetic factors play a significant role in determining a patient’s tendency to develop capsular contracture. Patients who have issues like an autoimmune disorder, or if someone in your family has gotten capsular contracture in the past, then your risk of capsular contracture is higher. Despite the advancements made in the medical field, it is not easy to accurately forecast as to whether you will get capsular contracture after the procedure. In some cases, capsular contracture is caused by external factors. It is now commonly believed that a thin layer of bacteria called biofilm that develops around the implants causes capsular contracture. This type of bacteria triggers a low-grade infection that may not present obvious symptoms. Instead, it triggers the development of a fibrous scar tissue that takes the shape of capsular contracture. This happens when your body produces more collagen to cope with the infection and seal the incisions. Biofilm bacteria are present on the skin of most patients who get capsular contracture. However, they do not present any symptoms unless the skin gets incisions and the bacteria spreads to the incisions and causes capsular contracture. Seroma and hematoma are yet additional factors that are associated with the development of capsular contracture. How is capsular contracture treated? If the capsular contracture is severe, creating physical pain for you and changes your butt shape, then the only way to treat the problem is through surgery. The surgical treatment of capsular contracture is a major operation like the initial butt implant surgery and is performed under general anesthesia. During the operation, the plastic surgeon will split open the incisions made during the butt implant surgery. He will then remove the scar tissue along with the implants. Once the implants are removed, the surgeon will suture and close the incisions. Since the implants are removed during the surgery, you will also lose the results. In other words, it means your butt will become smaller again because the implants are no longer inside your booty. Also, you will be required to go through a complete recovery process after the procedure. The primary recovery period after removal of the butt implants and scar tissue comprises the first two weeks following the procedure. During this time, you must stay in bed and take sufficient rest. You must avoid work and instead focus on your recovery during this time. Your body needs time and strength to recuperate from the surgical trauma. Complete recovery can take six weeks, after which you can resume work and other physical activities. If you still want to get bigger buttocks after the removal of the implants, you should consult with a board-certified plastic surgeon experienced in butt implant surgery. Usually, patients can get new butt implants a few months after the treatment of capsular contracture. A second and modern option to treat capsular contracture is carried out through a multi-energy therapy called Aspen. This procedure is not invasive, meaning you will not experience any pain or discomforts. Also, it does not expose you to the recurrence of capsular contracture. This procedure involves the use of a particular apparatus called Aspen harmonizer without any incisions. The device is applied to the capsule, which then emits ultrasound waves to the tissue. As a result, healthy collagen is generated, which improves the elasticity within the capsular contracture that has developed around the implant. This makes the buttocks soft and flexible. How to prevent capsular contracture Even though it is not entirely possible to prevent capsular contracture from happening in each patient, there do exist some ways to decrease the risk of this complication. Below are the methods that can be used to reduce the risk of capsular contracture: – Proper screening of the patient: During the pre-operative consultation, patients are screened for factors that can trigger complications after the surgery. If the screening is done properly, it can decrease the risk of capsular contracture. – Choosing a suitable butt implant size and style: Using implants that are too large or not suitable for your butt dimensions can increase the risk of capsular contracture. Make sure to work with your plastic surgeon to select an implant that is suitable for your buttocks. – Implant placement: When the implants are placed over the gluteal muscle, it increases the risk of capsular contracture. To reduce this risk, you can ask your surgeon to put the implant under or over the gluteal muscle. – Massage: Gentle massage of the buttocks after the recovery period can help decrease the risk of capsular contracture because it facilitates the breast tissue to stay palpable. Conclusion Buttock implant surgery involves incisions that generally develop into scars in the weeks and months following the procedure. Scarring after the procedure is a normal phenomenon. In most cases, the scars usually develop and fade over time. However, in rare cases, the scar tissue starts to tighten around the implant. This condition is called capsular contracture. The tightening of the capsule is continuous and triggers pain in the buttocks. It also changes the butt shape, making it look abnormal. Many factors are held responsible for capsular contracture. I have discussed those factors above. Keep in mind that if the capsular contracture is severe, it is essential to have the condition treated. I have explained the treatment options for capsular contracture above.