I had sub-muscular silicone impants 4 weeks ago. My left breast has softened nicely, but my right is still hard. Could this be capsular contracture?
Is It Possible to Have Capsular Contracture After Only 4 Weeks Post Op?
Doctor Answers (9)
Can Capsular Contracture Be Diagnosed At Four Weeks?
Four weeks after surgery, if your breast is hard on one side, early capsular contracture can certainly be a diagnosis. Bob Ersek, M.D., of Houston, Texas, wrote a landmark paper on a "fibrous storm" where under certain conditions a capsular contracture can occur as early as a week after surgery.
I am sure your plastic surgeon will want to see you and evaluate the tight breast, but the short answer is "yes", you can have a capsular contracture for multiple reasons at one month.
Capsular Contracture 4 weeks postop
It would be hard to determine without an in office exam. Thank you for your question. Capsular Contracture is one of the main risks of breast augmentation. Classic signs are:
1. hardness/tightness of the implant
2. change in implant position (typically migrates towards the collarbone)
3. increased pain and stiffness on the associated side.
Based on your description, you should see a board certified plastic surgeon for evaluation of capsular contracture. If present, I would recommend a capsulectomy (removal of scar tissue) and implant exchange.
Factors to consider:
1. If your implants are above your muscle, you may want to consider switching to underneath the muscle, which lessens the risk of capsular contracture.
2. If your implants are above the muscle and you desire to keep them there, you may benefit from the use of a textured implant.
Early capsular contracture after breast augmentation
The tightness that you are experiencing may be a result of swelling, a hematoma, or early capsular contracture. An examination is absolutely essential in order to minimize early development of capsular contracture. At the 4 week interval, true capsular contracture vs. normal tissue capsule formation, are still viable options. Surgery90210
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Capsular contracture after 4 weeks
for the body to form scar tissue, it usually takes at least 6 weeks , so I doubt you are having a capsular contracture this soon after surgery. More likely is muscle spasm if placed under the muscle or a pocket that is still tight. I think you need to give it some time.
Breast augmentation at four weeks
It is unlikely that you have a capsular contracture at four weeks post-op from a breast augmentaion. Speak to yoru doctor but you probably have to give it a few months to settle.
BReast augmentation: one breast is firmer than the other
In general, it is difficult to diagnose a capsular contracture at this point because scar tissue is normally forming at this point up until 6 weeks after surgery. However, it may be easier to diagnose after 6 weeks if it continues to remain firmer than the other side. There may be a variety of other reasons while one breast is firmer than the other which include hematoma, seroma, swelling, size difference, implant volume differences, etc
Hard breast after 4 weeks...
A firm breast 4 weeks after surgery can be several things:
1- Most commonly it is just tissue tightness. Larger implants in tight pockets will feel very firm for up to 2 months after surgery. The breast on the side of hand dominance( right vs left) will usually soften first, since the patient uses the muscles on that side significantly more.
2- A blood collection (hematoma) can also make the breast feel firm; Bruising would be obvious.
3- An early capsular contracture can begin to be felt around this time, and will continue to worsen. If the tightness worsens over the next two weeks, you might have a capsular contracture.
Deep massage can help decrease the chances of capsular contracture
Though still very early, this could be a sign that you are developing capsular contracture. Aggressive massage at this point along with ultrasound therapy can make a big difference. Definitely consult with your surgeon.
Capsular Contracture After Only 4 Weeks after Breast Augmentation?
Regarding: "Is It Possible to Have Capsular Contracture After Only 4 Weeks Post Op? I had sub-muscular silicone impants 4 weeks ago. My left breast has softened nicely, but my right is still hard. Could this be capsular contracture?"
While capsular contracture is theoretically possible at 1 month after surgery, that is not likely. What is a more plausible explanation is that the implant pocket was under-dissected resulting in a "tight fit". In such cases, specific massaging may help. Please, discuss it with your surgeon and make sure you do what he/she advises you to do.
Dr. Peter Aldea
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.