Capsular contracture, 4 mos after surgery. PS advised addressing it surgically when I was ready. After a year, I scheduled surgery, and I woke to learn that an abscess was present. (Drain, antibiotics...implant removed, capsule left in) Its been 3 1/2 mos, and the capsule is round, baseball size and hard still, and seems to be affixed to my chest wall. Under the circumstances... should it not have also been removed? Is it possible that something is still festering in the capsule?
Abscessed Present in Implant After Capsular Contracture, Should I Remove Implant?
Doctor Answers (4)
Residual capsule after implant infection.
It is possible to have residual bacteria dormant in a capsule that remains. Having a firm capsule likely means fluid within the capsule (assuming it was not removed) if the implant space did not close. However, if an abscess were present, there would likely be some symptoms (fevers, pain, redness). Removal of the capsule at reaugmentation is recommended as well as a gramstain of any fluid within the space. This can give an intraoperative assessment of the presence of bacteria during surgery. Given the history, it would may also be prudent to place a drain at the time of reaugmentation.
Web reference: http://www.drbogue.com
I think if you have no ongoing fever,chills etc then the infection is probably gone,however the hardness you feel may be residual scar tissue from the infection.discuss this with your surgeon.
Capsule and abscess after breast augmentation
Are you sure the capsule wasn't removed already? Either way, you will need to have the remaining scar tissue removed both for aesthetic reasons and because bacteria hide in scar and can reassert an infection at any time.
You should wait at least six months for things to stabilize. When you have reached a plateau in your recovery you are a candidate for revision augmentation. My approach would be to prepare you for some degree of asymmetry since the other breast has nice soft tissues and the problem breast now has a significant amount of scar. During our first encounter I would assess the degree of scar involvement to help you anticipate the likely outcome.
In summary: no matter what was done before the ball of scar tissue needs to be removed during the next procedure, which should also include re-augmentation.
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Capsule removal with abscess.
This is a difficult question to answer as intra-operative decisions in these situations vary greatly. If you are still having dense scar tissue it may be necessary to have the remaining capsule removed. This is something you should discuss with your surgeon to formulate a plan of action.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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