Bottoming out or Capsular Contracture After Revision?

asked 2 years ago by texasgurl in Texas
Latest answer by Richard Linderman, MD
Question viewed 2,567 times
Tags: 090-109 lbs, 5 ft 4 in to 5 ft 7 in, saline implants, silicone implant, 350-399cc, 500-549cc, bottom out, capsular contracture, revision

105lbs 5"5'. First BA in April of 07' I had elected to go with 350cc saline through the belly button, the results were beautiful for about 8 months when I noticed hardening of the right breast.It was obvious that I had a capsulor contractor. After the second surgery in April 09 We replaced both implants with cohesive gel silicon 500cc with capsulectomy done on the right breast. Then in December 09' had to revise the left breast that had bottomed out. Now 4 months later im not sure if it is bottoming out again or another capsuler contractor or both!

9 answers to Bottoming out or Capsular Contracture After Revision?

Contracture after revision

Thanks for posting photos so we can TRY to give you a diagnosis and treatment options. First you must realize an in person examination is much better than an internet examine with photos. Now I feel the right breast is capsuled and an inferior capsulotomy is a choice. If the right implant is a 500 cc than that is all I would do for this side. Of course I would drain this side. For the left side, it appears as a bottoming out, kinda of. A side view would help, but with the frontal the view... more

Darryl J. Blinski, MD
Miami Plastic Surgeon

Revison and Revision

.Without examining your breasts, we are all only guessing. Are your implants the same 500cc size. The right appears smaller and may have capsular contracture. The left appears larger and lower. The surgery I recommend if the above is true takes experience and a good plastic surgeon. I would decreased the size of your implants, do a capsulectomy on the right. On the left would require implant exchange and a GOOD internal capsulorraphy with a support bra for six weeks. Placement of a collagen... more

Richard Linderman, MD
Indianapolis Plastic Surgeon

Implant issues

From the photo, and I would have preferred to see your hands down at your side and not lifted, the right one seems tight.

Steven Wallach, MD
Manhattan Plastic Surgeon

Bottoming out or Capsular Contracture After Revision

It is difficult to diagnose if the right is contracted but it does appear that your left is too low. I would recommend downsizing with caspsulotomy on right and capsulorrhaphy on left. .

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Do I have bottoming out or capsular contracture?

This is a difficult problem. As most of the responses have stated, you should definitely decrease the size of the implants at the next (hopefully last) operation. The left inframammary fold should be raised and any capsular contracture that you can feel should be fixed (especially on the right). Good luck.

Sirish Maddali, MD
Portland Plastic Surgeon

Revision breast surgery

You are heading down the slippery slope of the multiply operated breast implant patient. There is a point where you will never have a good result because of scar tissue and tissue memory. You probably have one last chance for a decent, but not perfect, outcome. Make sure you are in the hands of the very best breast plastic surgeon in your area and listen to their advice even if it means going smaller. The photos might well indicate a recurrent cc on the right because of the elevation... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Revision breast augmentation.

Hi. 1) Just going by your picture, you don't have "bottoming out". 2) You may well have contracture of the right breast. The right fold is much higher than the left. 3) I recommend smaller breast implants.

George J. Beraka, MD
Manhattan Plastic Surgeon

Your infra-mammary fold is lowered too much

The inframmamary is too low over the left breast. Your implants are above the muscle. The other issue is the size of the implant. You have too big a implant and you can see the extension of the implant edge in the midline. The diagnosis of the capsular contracture is very hard from the pictures that you have attached. I would recommened that you see your doctor and ask him about this. Your story of implant problems is very common with transumbilical augmentation.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Need for a revision procedure

It's hard to know if you have capsular contracture on the right side without examining you, but it's possible that you do along with some bottoming out on the left. If you have had a repeat of the bottoming out on the left side, one option for correction would be to use a product like Strattice to act like an internal sling to help hold the implant in a better position (your surgeon can tell you more about this product). The down side is that the product is not cheap, but in cases of... more