Should I wait a couple more months to decide to get revision surgery for my capsular contracture for the second time? I had my first breast augmentation on 10/01/08. Got CC within the first month. Got my revision surgery on 04/15/09. Got CC again within the first month. I'm not happy and I want a 2nd revision surgery by a different plastic surgeon. Its only been 3 months, should I wait longer?
Wait for Revision Surgery for Second Capsular Contracture?
Doctor Answers (6)
There are many reasons why you may be developing capsular contracture. However, right off the bat I would say the implants are way too large for you and overly projecting, likely high profile. You need smaller implants and some work done in the pocket. Dont know if you are behind the muscle, I would say likely, but if you are not theny that also needs to be addressed. Dont know if you were instructed on implant massage. Also your next surgery, I would recommend starting on accolate right after your surgery and keeping on it for 3-6 months, this is an off label use and you need to discuss this with your plastic surgeon for the risks and benefits.
If plan A does not work do not do plan A again
It appears that you had your surgery through a peri-areolar incision. You did not mention if you have silicone gel or saline implants or if your implants were above or behind the pectoralis muscle. It appears that you have a good deal of asymmetry with the left implant higher than the left. It is quite unusual to develop a bilateral capsular contracture 4 weeks post op. There are several options that may be alternatives to help correct your situation. A good rule is "if plan A does not work to not do plan A again". Which is may be what has happened to you. We must do something different or the same result is inevitable. Suggestions include:
1. using a smaller implant
2. If the implant is subglandular place it submuscular
3. use a textured implant
4. irrigate the breast implant pocket with a triple antibiotic solution
5. consider taking a medication such as Accolade or Singulaire, may help decrease the incidence of capsular contracture
6. vigorous post op massage
Get opinions from several plastic surgeons and develop a plan that is right your you.
You should wait at least 6 months.
You should wait at least 6 months. But I am afraid capsular contracture is not your only problem.
1) Your breast implants are much too big and they make your chest look overstuffed.
2) Your implants are too high.
3) Your implants are not symmetrical ( left higher).
4) Your nipples are pointing down.
All of these things can be corrected if your plastic surgeon has the right plan.
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Timing for capsular contracture repair
A good rule of thumb is to wait at least six months after your surgery before fixing a capsular contracture. That allows enough time for the scar tissue to mature and soften.
However, based on the photo you posted and how early your symptoms have presented, you may not have a capsular contracture. Capsular contracture usually presents as a breast that slowly hardens over time after having first been softer.
In your case, the problem might be that your implants are too big for the pockets holding them. This too will make your breasts hard and distorted but the cause is different and so is the treatment.
When should I have a breast revision for capsular contracture?
I would wait another three months.After your prior surgery,to allow your breast to completely heal, I would suggest you wait a total of six months. At six months, your breasts will have healed. At that time, I would consult with your board-certified plastic surgeon for a breast implant revision. I would do several things. First of all, I would change the implants. Secondly, I believe silicone implants should decrease your chances of recurrent capsular contracture. Thirdly, I would change the position of your breast implant pocket: if you have a breast implant pocket under the muscle, I would change it to above the muscle; if you have a breast implant pocket above the muscle, I would change it to below the muscle. To minimize the chance of breast implant capsular contracture, the position of the implant influences the choice of a textured or a smooth implant. Fourthly, I would perform bilateral breast capsulectomies. Often, a breast capsulectomy procedure is covered by most medical insurance companies. Please ask your board-certified plastic surgeon to submit for authorization. Fifthly, I would use Strattice. This has been shown to decrease the incidence of capsular contractures. During and after surgery, I would also use antibiotics. After surgery, I would also encourage the use of Singular. In addition I would also suggest breast implant displacement exercises to start two or three weeks after surgery.
Web reference: http://www.breastcapsulectomy.com
Wait at least 6 month before Breast Revision
The short answer is to wait at least 6 months from your last surgery. There are some other concerns your new plastic surgeon will discuss with you such as your asymmetry and range of sizes of implants that would work best for you in light of your desired goals.
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.
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