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Can Implant Exchange Increase Capsular Contracture Risk?

asked 3 years ago by Amelie82 in UK
Latest answer by Ivan Thomas, MD
Question viewed 4,346 times
Tags: capsular contracture, side effects

I have had implants for 7.5 years with no problems that I am aware of! However, they are def larger than is proportional with my frame as my rib cage is very small and they make me a 32DD when I was a small B before. I would ideally like them to be a C- cup and to maybe sit a tiny bit lower and am therefore considering having smaller implants put in.

Would you advise keeping the implants in the same position or moving placement? They are currently placed above the muscle as I am a personal trainer and aerobics instructor and didn't want any of the muscle jumping etc... associated with under the muscle placement.

However I am mainly concerned with keeping the likelihood of capsular contraction down to a minimum- is using the original pocket for a new smaller implant going to increase the chances of this occuring do you think? Thanks in advance!

20 answers to Can Implant Exchange Increase Capsular Contracture Risk?

Risk of Capsular Contracture with implant exchange

Exchange of implants is unlikely to increase the chance of capsular contracture. Exchange of smaller implants is not simple removing the large ones and replacing it with a smaller size. It requires several steps: The large pockets have to be closed, Any capsule that has formed should be removed and, The pockets adjusted for the new implants. Since you are down sizing the implants, you may not need to lower the pocket. However, your surgeon should be able to... more

Ivan Thomas, MD
Los Angeles Plastic Surgeon

Stay where you are

If your implants have no evidence of capsular contracture now, changing to smaller ones in the same pocket should not increase this risk. I personally prefer submuscular implants even in body builders and personal trainers, but I wouldn't recommend you change to submuscular if you are having no problems above the muscle.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Stay with your current implant placement

Amelie82: I agree with your concern that subglandular implants could develop capsular contracture. In addition, new operation / re-operation may possible lead to contracture (but so could sub-muscular repositioning). I do not think the chances of contracture would be higher to use the same pocket. Having new, smaller implants in the same pocket sounds reasonable to me given your good results with your current implants. After examining you, your surgeon will advise you whether some form of... more

Sutton Graham II, MD
Greenville Plastic Surgeon

Replacing your implant with a smaller one in the same pocket should be fine if using a gel implant.

Replacing your implant with a smaller one in the same pocket should be fine if using a gel implant. If you are thin with little breast tissue, you will want to avoid a saline implant in the subglandular position to avoid rippling. With regards to capsular contracture, you should be fine keeping your implants in the same pocket if you currently have soft breasts. Realize, however, that anyone with silicone implants can at some point develop a capsular contracture. There is evidence to... more

Sanjay Grover MD
Orange County Plastic Surgeon

A smaller implant is fine in the same pocket

Since you have no problems with your implants currently, if you want to go smaller, then I would keep the implants in the same pocket. The body does a good job of ridding itself of extra space, and since your capsule is currently in good shape, it usually will continue to be after explant/reimplant surgery. Since you are a trainer, your skin may be in good enough shape to tighten around the smaller implant, but you can't rule out the possible need for a mastopexy. Discuss these concerns with... more

Shain A. Cuber, MD
Marlboro Plastic Surgeon

www.AssociatesinPlasticSurgery.com

Keep the implants in the same pocket.

Amelie82, Unless you have some problem with the shape or level of the implants, you should have the new implants placed in the same pocket. If you change pockets, it will require more dissection and a longer surgery and may not end up looking as good as they do now. Good luck with your surgery.

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

No increase in capsular contracture risk with smaller implant placement

Amelie82, Placing a smaller breast implant into a large pocket should not per se increase your risk of capsular contracture. The smaller implant in a larger pocket will drop the implant a bit, which is what you want. If you want to reduce the chance of capsular contracture to the minimum possible then I would consider placing the new breast implants under the muscle. Sub muscular breast augmentation reduces the risk of capsules. Depending on how much skin laxity has been caused by the... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

Implant exchange: Downsize? Change plane? Capsular contracture risk?

Implant exchanges are common. To address your concerns, which are well thought out and valid: 1. Downsizing. If you are not droopy, then you can likely downsize with a simple exchange. If you have thinning of the skin, you are droopy (you can pass the pencil test), or you have visible ripples and wrinkles, you may not be able to just put in a smaller implant without doing some other kind of procedure such as changing the plane or lifting and tightening the skin... more

Lauren Greenberg, MD
Palo Alto Plastic Surgeon

Reoperation for breast implants reintroduces the risks of the operation.

I would think carefully about replacement of your implants. It is possible that you could develop capsular contracture in spite of your good result the first time. In addition, all the other risks of surgery are inherited.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon

Can implant exchange cause breast hardening?

Any surgery on the breast can increase your risk of capsular contracture, as there is a risk of bacterial contamination with each procedure. However, the risk is pretty low, since you don't currently have a contracture. I would leave your implants in the same prepectoral (above the muscle) position and just downsize them.

Carmen Kavali, MD
Atlanta Plastic Surgeon

Changing the position of the breast implant with an exchange

Exchange of implants is most easily performed in the same plane. I would recommend maintaining the same implant pocket and repositioning under the muscle if there is significant risk of capsular contracture. There are no immediate reasons for you to replace the position to subpectoral.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

There is no reason to change implant position

After seven years and the only complaint you have is that they are too large, I would keep them in the same position. It would be a 30 minute procedure to remove and replace the implants. You do not have any increased risk of capsular contracture.

Gary H. Manchester, MD
San Diego Plastic Surgeon

www.manchesterclinic.com

If it is not broken...then don't fix it.

If you have had success with your current implants in the subglandular position, then you should be fine to have them removed and replaced in the same position. However, if you have had problems with implants in the subglandular position (i.e. visible or palpable rippling, capsular contracture, unnatural appearance) then having them moved to the sub-muscular position is a good choice. Implants in the subglandular position do have a higher risk of developing capsular contracture in... more

Kevin Brenner, MD
Los Angeles Plastic Surgeon

Many personal trainers put them under the muscle

You have large implants above the muscle. First, the skin has stretched out, Second, the implants will sag sooner in this position and look less natural than if they were placed under the muscle. My suggestion is to put the implants under the muscle and close the pocket while lifting the breast internally. Thismeans when you close the pocket, the suture also lift the breast tissue a little - quite easy, really.

Robert M. Freund, MD
New York Plastic Surgeon

Implant exchange should not increase capsular contracture risk

As far as I know, removing breast implants or exchanging them with another set of implants should not increase the risk of capsular contracture. As you know, capsular contracture is a risk with any breast implants. The exact causes of capsular contracture are not completely known. However, an exchange of implants should not increase the risk of capsular contracture.

B. Pat Pazmino, MD
Miami Plastic Surgeon

Breast Implant exchange

If your implants have not caused problems up to this point, then you probably are in good shape to not get a caspular contracture. I would probably leave them in the same pocket and just exchange them. You may need to the pocket tightened to accomodate the smaller implants and/or possibly a lift.

Steven Wallach, MD
Manhattan Plastic Surgeon

Capsular Contracture and Implants

At this point you would simply remove and replace your implants with mainly silicone as your implants are in front of the muscle. I would leave things be as far as not going under the muscle right now as you are doing fine and you have not had a capsule formation in 7 years of having subglandular implants. Patient with subglandular implants do have a slightly higher risk of capsular contracture.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Smaller breast implants should be OK

Hello, The only thing I would consider to reduce your risk of capsular contracture is to place the implants under the Pectoral muscles which you have said you don't want. You may develop contracture later, but if you haven't in the last 7 years or so, it shouldn't be any time soon.

John P. Di Saia, MD
Orange Plastic Surgeon

No

You should be fine with just changing to a smaller implant, within reason. Of course, there is no guarantee that you won't get a contracture as a result of the surgery. On the other hand, if you change to submuscular position, this may cause the need for a breast lift due to the stretching of the tissue above the muscle.

Scott E. Kasden, MD
Dallas Plastic Surgeon

You can use the same pocket for breast implant replacement

To Amelie82, Hi! You should definitely get smaller implants. Huge implants don't age well. You can use the same pocket, and it may have to be made a little smaller with internal sutures (capsulorrhaphy) to accomodate the smaller implants. If the very large implants have stretched out your breasts, you may want to consider doing a lift at the same time.