I just got an email from a new patient asking if she has had keloids if it increases her risk for capsular contracture.
My initial reaction was no, because from what we know we think the primary cause for capsular contracture is biofilm, a low grade inflammation / infection. Read my numerous blogs on it HERE. But I do put my patients on Singulair after surgery as they form their capsule to try and help the capsule be softer. Blogs on that HERE. So we know we don’t know everything about capsular contractures, and why they form. Like all things, it is likely multifactorial.
I thought it warranted a search. So I went to PubMed.
When I looked at the terms “keloid” and “capsular contracture” I did find one scientific study from 2015 “Botulinum Toxin A affects Early Capsule Formation Around Silicone Implants in a Rat Model” Annals of Plastic Surgery April 2015. In their study they state “Peri implant capsules are histologically similar to keloid scars and hypertrophic scars.” They hypothesized that Botox has been show in some studies to reduce keloid scars. Their study was to create capsules in rats, injecting some with botox around the breast implant, in others just saline.
Findings? The experimental group at six weeks showed statistically less thickness, less inflammatory cells, less vessels, and less transforming growth factor beta 1 expression. The collagen pattern was loose and well organized. The myofibroblast content was lower (though not statistically significant).
So what do I think?
The Botox in rat model is not prime time. We aren’t going to start injecting Botox into our breast implant patients anytime soon.
I did not know of Botox helping with keloids (I love that I am always learning). So if the pattern of scarring in capsular contractures is similar to keloids, and a treatment for keloids also helps treat capsular contracture, then there is likely some link. How strong that link is remains to be seen.
Also I have many people who think they have a keloid who really just have a widened or bad scar. See my blogs on keloids HERE.
So are you at higher risk? I don’t know.
I am curious about using botox for keloid scars. This is new evolving science. Look for my upcoming blogs on the subject.