Breast revision surgery after unsuccessful closed capsulectomy. What are the chances of CC returning?
Doctor Answers (8)
Am I At A Higher Risk For Capsular Contracture If I Have Had A Previous Capsular Contracture?
1. One's immune system - If you have an immune system that overly protects you against any foreign invader, i.e. an artificial hip, pacemaker, breast implant, etc., then it is very likely that you will get a second capsular contracture. Fortunately, this type of immune response is very, very rare.
2. Blood around a breast implant - Blood around a breast implant increases the chance of a capsular contracture significantly, and a hematoma (large collection of blood) almost certainly means a second capsular contracture.
3. Non-pathogenic bacteria (one's own skin bacteria) - This increases the likelihood of a second capsular contracture, whether leftover from the previous capsulectomy or being introduced in the redo surgery.
4. All the above - Obviously, a combination of any of the above three will certainly lead to a second capsular contracture.
5. Unknown - Obviously, the science of capsular contracture hasn't been completely worked out yet. All foreign bodies in the human body are surrounded by a scar known as a capsule. The mechanism that changes a capsule into a contracted capsule is not fully understood at this time.
A general answer to your question of "are you at a greater risk for a second capsular contracture" is possibly yes depending on which of the above causative factors were involved in your first capsular contracture.
#BreastImplantRevision - What are the chances of CC returning?
Putting the implant under the muscle makes sense, as does switching to textured implants (in general...and there are advantages and disadvantages to every decision). Most surgeons wash/soak the implants in an antibiotic solution.
Beyond that it's not clear what else can be done (the medicine Singulair has been used, with some success, but there are downsides to that, too).
I hope that this helps and good luck,
Dr. Alan Engler
Member of RealSelf100
Breast Implant Removal
Sorry you are having all this trouble. Yes you would be at a slightly higher risk. The past is the best predictor of the future. Still, it should be only about 3% or a little more with a new pocket under the muscle. Ask you PS about using the medication, off label, called Singulair. All the best, Dr. Joe
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Breast revision for capsular contraction and ruptured implant
I would suggest that you try Accolate or Singulair. Patients usually can't notice any difference after they start the medication and the risks are minimal. There is no guarantee that this will prevent firmness, but many of us believe that it helps.
If you do have a recurrence, the other surgical maneuvers that could help are the use of textured silicone implants, possibly the cohesive gel implants such as Allergan's 410. I would also try the placement of an acellular dermal matrix such as Strattice.
I'm sorry to hear that you developed capsular contracture and that you eventually required open capsulectomy and replacement of implants.
I agree with the previous answers. Overall you are probably at an increased chance of developing a capsular contracture compared to a woman receiving implants for the first time. Its very difficult to quantify the level of risk however. If your new implants have a textured surface then they probably have a slightly lower chance of causing contracture. Also, the neo-pocket and sub-muscular placement are known to reduce the risk of contracture.
The surgery you have undergone has probably given you the best chance of avoiding a recurrence of the problem.
Joe's suggestion of Singulair is worth investigating. It wont hurt and there is (weak) evidence that it could help. I hope this helps.
No guarantees with revisional surgery for capsular contracture.
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