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?

Doctor Answers 13

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, placement of of allograft (skin substitute) is showing promise and I have personally had good results using this for the treatment of capsular contracture. It has been proven helpful in animal models and some clinical case studies. A large well done study is not yet available. There is nothing you can do to prevent this from happening again. The other options of vitamin E, massage, singulair, etc have not been shown to decrease the rate of capsular contracture. To my knowledge external ultrasound has not been studied. None of these methods have a significant downside and I would not necessarily discourage a patient of mie from trying them, but I do not advocate them. Fat grafting may been a viable option to augment the breast for implant failures although this is not FDA approved and our society's position is that this needs further investigation before becoming a recommended option. Depending on the size implants you have, fat grafting may not be able to duplicate the size increase.

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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.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 12 reviews

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.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 16 reviews

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.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon
4.5 out of 5 stars 23 reviews

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
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

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 I know I made them at surgery, and I have been able to "push" the implants around better than the patient can and "open " them back up...if done early.  So, I would go see your surgeon about your concerns.  By the way, I echo the concern oer having 5 surgeries in a one year period...this is highly unusual and I wonder if you should get a second opinion as well.

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
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

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
Long Beach Plastic Surgeon
5.0 out of 5 stars 20 reviews

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/.

Ernesto Hayn, MD
West Palm Beach Plastic Surgeon

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
New Orleans Plastic Surgeon
4.5 out of 5 stars 70 reviews

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.