Breast Augmentation: Q&A

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How Soon After Surgery Can You Tell if You Are Encapsulating?

I have had 5 breast surgeries this year,(one implant exchange, two capsulectomies on the same side, hematoma on same side, and exploration and pocket cleaning/draining, same side) I am two weeks post op and my breast feels tight, and when I take a deep breath, it feels like way inside the breast is kind of stretching or pulling. PS says it's normal, but I have developed 2 capsules already and would like to prevent another from forming. Any advice/help?

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13 Doctor Answers | Asked by yoamba in Long Beach, CA

Doctor Answers (13)
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Capsular contracture

As others have indicated the cause of capsular contracture is unknown. Bacterial involvement is currently a popular theory. Treatment can be frustrating with recurrence being common. The capsule does not start to form until about three weeks. Tightening can occur at any point. Although you could be experiencing swelling, it would be a little early for you to have capsular contracture. Depending upon the treatment you had, it may have been inadequate. For recurrent capsular contracture,... more

Michael Hueneke, MD

6 reviews

Nashville Plastic Surgeon

Breast Augmentation

With two previous capsule contractures you are clearly at higher risk than normal. But, feeling tight after surgery is fairly normal and I think it is too soon to make that determination. Allow 6-8 weeks to pass before any decisions are made. Your Board Certified Plastic Surgeon will be able to determine the capsule formation if one occurs.

Capsular contracture recurrence?

Based on the your prior experiences, you may be prone to development of capsular contractors. Of course, it would be natural to be highly sensitive to any tightness in the breast. You should follow up with your plastic surgeon at regular intervals, perhaps every two weeks given the history. I do share the concern of others on this forum that, if you do go on to develop a capsule, you will have to seriously discuss your options, including foregoing implants, with your plastic surgeon. more

Five breast surgeries in one year is way too much

You have had a bad time. This is too much surgery and too many problems. Aside from the cause, operating on any tissues so often makes scarring much more intense and never allows the healing from one operation to finish before the trauma of another operation. Regardless of what is happening, you need 6-12 months without surgery for your breasts to recover. Then find an experienced surgeon who can advise you. Good luck.

Capsular contracture

It is too early to tell if your capsule is returning. You definitely are at a higher risk with your previous history for recurrence. If your capsule does return discuss with your surgeon the use of acellular dermal matrix which has been shown to decrease capsule reformation. It is expensive though but may save additional costly surgery. Donald R Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD, DDS

3 reviews

Atlanta Plastic Surgeon

Capsular contracture after Augmentation, how soon?

I have seen capsular contracture as early as 2 weeks post op, or at least a pocket that is possibly heading in that direction. I have my patients do implant displacement exercises, and I see them every couple of weeks to make sure they are doing them correctly and to assess whether their pockets are staying open and the implants softening as I would expect, or whether the pockets are closing down. I certainly have sseen patients at two weeks whose pockets are not as "open" as... more

Breast augmentation

5 surgeries in one year is an awful lot. I think some of the opinions stated are very valid. You may or may not be developing a capsule again. If you are developing a capsule, then I suggest that you may want to take the implants out for a while and then consider doing them again in about 6 months or not having them replaced.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

5 surgeries in one year

Have you considered getting a second opinion? In twenty years of private practice I have never heard of anyone getting 5 surgeries in a year, let alone on the same breast. Unless something is done differently, the likelihood of a recurrence of your contracture is high.

Marcel Daniels, MD

12 reviews

Long Beach Plastic Surgeon

Capsular contracture usually starts early, but can occur late as well.

One of your breasts has had all 5 operations, and all of the capsular contractures. Based on this, and if your other breast is soft and without capsular contracture, this is NOT a healing characteristic related to YOU, but rather another reason that your one breast has repeatedly re-formed a contracture. The most common causes of capsular contracture are bleeding and bacteria (not necessarily a true "infection," but rather implant contamination from skin or intraductal... more

Capsule post breast surgery

I myself like Dr. Virden also am an advocate of external ultrasound and massage. You are a prime candidte for capsular contracture as you have had them in the past and the hematoma can also increase the chances of contractures. I recommend you see your surgeon and ask about the availability of ultasound therapy in your area/.

You have higher risk of capsular contracture

Your case is very unusual and you have very high risk of contracture recurrence. You may be candidate to remove implants and take a break from implants for 3-6 months. After that time new implants and new pocket may help. The second option would be implant removal and fat grafting. I been offering this option for patients with implant failure fir last 4 years. You may check my websit at khoobehi.com.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Would like to prevent another Breast Scar Capsule from forming

Having 5 operations on a breast in one year must be a record. Per your history you had "one implant exchange, two capsulectomies on the same side, hematoma on same side, and exploration and pocket cleaning/draining, same side". While it is unclear WHY you had an implant exchange (leak VS wanting to go bigger), it is clear that you are prone to forming capsular contractures. While the risk of forming capsular contractures is 15% with an initial breast augmentation, having had a... more

Preventing Breast Capsules

Wow, 5 surgeries are a set up for Encapsulation. I am a big advocate for external ultrasound and message. You must stay with the message program and I have advocated using a simple kitchen dough roller to assist with your pressure during message. Also being on a medicine called Accolate or Singulaire can be of some help to less the formation of a capsule. Stay persistent and don't give up. You need to possibly find some one in your area that does external ultrasound.