Breast Reduction + Implants and Capsular Contracture - What Should I Do?

Had breast reduction w/silicone impl same time ~ 1yr ago,D to B. Wanted breast that look full& my surgeon said can't achieve with reduct. & lift so I wanted 250CC of impls placed. I had infection,hematoma of R breast 7-10 days post & Irecovered. Shortly after I developed capsular contracture W/ lots of pain & he had to break them by squeezing. Same thing happened again now & have 2 options:take impls out& have flatA cup or another surgery to clean & place new implants,I don’t know what to do?

Doctor Answers (4)

Recurrent capsules and implants

+1

First, closed capsulotomies are not recommended.  Second, it sound like you need a caspulectomy( removal) and probable implant removal and you may need to start over in a few months.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

REcurrent capsular contracture with implanted breast reduction

+1

If you desire the upper breast fullness, I would recommend one more attempt at implant removal, replacement and a neopectoral pocket.

Web reference: http://www.bodysculptor.com/breast-surgery-chicago/breast-reduction/

Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Revision likely

+1

If you want to keep some fullness, then the implants should be removed and replaced as well as removal of the breast capsule.  If the current implants were placed above the muscle I would placed them beneath the muscle during surgery.  I would not recommend a closed capsulotomy (squeezing to break the capsule) because this can cause more bleeding and damage the implant.

Good Luck

Dr. ES

Atlanta Plastic Surgeon
5.0 out of 5 stars 6 reviews

Managing a COMPLEX Breast reduction, Augmentation and Capsular Contracture case

+1

Regarding ; "Had breast reduction w/silicone impl same time ~ 1yr ago,D to B. Wanted breast that look full& my surgeon said can't achieve with reduct. & lift so I wanted 250CC of impls placed. I had infection,hematoma of R breast 7-10 days post & Irecovered. Shortly after I developed capsular contracture W/ lots of pain & he had to break them by squeezing. Same thing happened again now & have 2 options:take impls out& have flatA cup or another surgery to clean & place new implants,I don’t know what to do?"

Several items in your question are very inconsistent. It is very unclear to me why with a D cup breast you could not JUST have a breast Lift. After all, a Breast Reduction makes breast smaller. So WHY would you need to reduce the breasts only to increase their volume with silicone gel implants?

The likelihood of capsular contracture is increased by EITHER bleeding or infection. Having had both made the likelihood of this complication an almost certainty.  The "treatment" you had undergone CLOSED CAPSULOTOMY (attempting to break the scar tissue by using the implant as a bettering ram..) is rarely used these days and if the implant is ruptured in so doing both Allergan and Mentor will NOT give you a free implant.  Even if it works the relief is temporary as the scar reforms rapidly. This is exactly what happened to you. This makes me wonder if your surgeon is a member of The American Society of Plastic Surgeons (plasticsurgery.org).

Finally with a recurrent painful contracture your options would depend if you still have an infection. In the face of a sub clinical infection most efforts are doomed to fail and it is best to remove the implants for at least 6 months while the area heals. If there is NO infection and you are willing to take a higher chance of recurrence of scarring you may need scar and implant removal, pocket irrigation and placement of NEW implants with either Strattice or Alloderm to inhibit scar reforming. A very expensive operation not covered by insurance.

Good Luck.

Dr. Aldea

Memphis Plastic Surgeon
5.0 out of 5 stars 52 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.

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