I just had a breast augmentation with a crescent lift 10 days ago. My left breast has already settled in nicely, but my right breast still sits high on my chest, my ps has told me this is quite normal, my concern is the inside of my right breast is nice and full but the lower outside looks flat and deflated still, could this be an early sign of capsular contraction? How early can capsular contraction start?
How Early Can Capsular Contraction Start and What Are the Symptoms?
Doctor Answers (11)
Capsular Contracture Timeline and Symptoms
Your plastic surgeon is probably right.
Although capsular contractures following breast augmentation can occur just about anytime, most women start having symptoms around three months after their breast implant surgery. This is because it takes some time for a capsule to form and then to scar down (contracture). Therefore it is probably too early at 10 days to be concerned about this problem. Your signs and symptoms are most likely from muscle spasm although other factors could also cause this. Your plastic surgeon should be able to sort this our in short order.
Signs and symptoms are going from a soft breast in good position to a hard one that looks hard and round like a ball usually after 3 months that tends to ride up your chest and can eventually be painful.(i.e. hard, deformed, displaced)
Unlikely contracture this early
Capsular Contracture can start early when there is infection or another co-existing problem. It is rare however. It is more likely this early that one implant has simply not "dropped" yet. This can happen when the muscular tone on one side is greater than that on the other. Follow the progress along with your surgeon. It might take a few weeks to a month to sort out.
Capsular Contracture May Occur At Any Time Following Breast Augmentation
Capsular contracture can occur at anytime following breast augmentation surgery. Most cases become apparent three to four months following surgery. The incidence of capsular contracture continues to slowly increase as long as patients have breast implants.
It’s unlikely that you have a capsular contracture. In the immediate post-operative period, breast firmness is usually the result of swelling and not capsular contracture. In most of these cases, the firmness resolves with the passage of time and massage.
If you’re breast firmness fails to respond over the course of time to conservative maneuvers, you may have a capsular contracture. This can result in breast firmness, breast distortion, and pain. Consultation with your plastic surgeon should clarify this issue.
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Relax, follow your surgeons advice
When ever you operate on two sides of the body they frequently act like they are on two different people. Early asymmetry and differences in shape and feel are absoluetly normal. One side always drops faster, feels softer, has less pain and less brusing. Relax, follow your surgeons advice.
I have seen contracture start ~2 weeks, perhaps sooner
This is quite rare, however. I would defer to the surgeon, as he has benefit of exam, and he knows the technique. If, for example, the implants are under the muscle, they do tend to "hang" for 3 to 4 weeks before descending. Also, each breast is unique, and settles at its own rate. Don't let that make you nuts.
The contracture is due to excessive scar tissue squeezing the implant, and this can cause the implant to become hard, deformed, displaced. It can also cause pain. I would hold tight, don't get too anxious, and re-visit the question on next visit.
Too soon for you to be worried about capsular contraction
To form a "capsule" is normal, and it's simply a term for the normally occuring scar around the implant. Contracture, or tightening of the scar around the impant is unpredictable, and at 10 days after the surgery, I think it's way too soon for you to be concerned about the capsule contracting. You have to trust your surgeon and speak with his/her office for further advice.
Uneven Breast Implants
Although capsular contracture may begin soon after breast augmentation, it is highly unlikely at this point.
I would ventrue that your breasts may have been slightly uneven to begin with your right being slightly lower/larger. Some implants take a while to descent into the breast and this sounds as if this is what you are describing. Occasionally, we have patients perform preferential breast implants on the higher side to "encourage" the implant to settle faster.
Given the early time after surgery, it is likely your breast implant will settle over time and this may take 6-9 months to fully assess. There may be many reasons why one implant sits higher than the other. In some instances this may require surgery at a later date but that decision is best deferred for now. I have seen many implants even out over time.
Discuss your concerns with your surgeon and try to be patient.
Most likely not a contracture
It is unlikely for a contracture to occur this early unless you had significant bleeding or an infection. It sounds as if the pocket is not large enough on the one side or just hasn't dropped yet. As I wrote earlier, most implants take 4-6 weeks to settle into place, so don't rush or worry.
Follow the doctor's order for massage and exercise.
It is partially up to you now
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