7 weeks post op, Is This Capsular Contracture? (photos)

I've had a surgery over 7 weeks ago,2nd one,got 400HP in left breast,and 375HP in right one,due to small assymetry.My left breast healed well.Right was difficult,bleeded more,and there was a swelling on the right side of the breast(bottom part below armpit)that was soft at the beginning.When I squeezed it with my hand it felt like some fluid.It hardened with time,after few weeks it's better.I found a swelled vein under right one. 2 weeks post op right breast appeared smaller,and it's still so.

Doctor Answers (10)

7 weeks is too early to diagnose a capsular contracture.

+2

At 7 weeks swelling the breast after augmentation might make the breasts appear to be suffering from capsular contracture.  Whereas the capsule that forms around all implants is visible after a few days, capsular contracture usually does not emerge for several months at the earliest.


Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Is this capsular contracture?

+2

based on your photo, it appears that the right breast is in fine position and that the left breast is too low. they both appear slightly  "shrink wrapped". this could be a subtle early contracture. your history of bleeding and swelling make me suspicious. there are some non-invasive strategies to employ.talk to your surgeon early. but I fear the left breast will be the problem as generally a low breast only gets lower. if it does bottom out another surgery to re-create the inframammary fold will be necessary. sometimes a cellular dermis is required and if this is your third operation I would recommend it. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Capsular contracture after seven weeks

+2

Capsular contracture causes the breast implant to become firm and round up within the breast. An early capsule can be felt with drawing and firmness, and a later capsule becoming visible with distortion of the breast. What we note in your photo is that one of the implants is low with a pocket below the natural fold. The high profile implant is now projecting below the nipple causing the nipple to appear higher on the one breast. We don't think massage will get you anywhere. Wait at least six months and if you cannot live with the asymmetry a revision is in order.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

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Capsular contracture

+2

Dear Violet,

Thank you for the pictures.  There are several possiblities that may be considered at this time.  From your pictures it appears that the fold below your breasts (inframammary fold) are not at the same location.  After 7 weeks the implants should have started to, or should already descended into the appropriate anatomical location.  The issues that you had with your R breast may have impeded the descent expected, and/or possibly have caused the formation of a capsular in the area impeding the descent.  The other possibilities are that the implant on the L has descended and the one on the right still has to do so; also the surgical dissection of the L breast inframmamary fold might have been lower than the dissection on the right.  All of these are possibilities.  As always I suggest you see your surgeon as soon as possible as simple massage to ultrasound therapies can be used to help with the issues that you are currently having.  Good luck.

Ernesto Hayn, MD
West Palm Beach Plastic Surgeon

Is this capsular contracture?

+2

You mentioned this was a 2nd surgery.  Redo's can be more difficult than primaries. What is the sequence of the photos that you have posted?   At 7 weeks post op, it is too early to identify a capsular contracture.  Your right breast doesn't look bad.  Your left breast is  bottomming out, and that may be the reason for your current asymmetry.  You should be massaging the breasts  daily.  The right side may still drop so that is looks more like the left.  When an implant bottoms out, it may actually look larger and this may be why the opposite side looks smaller to you. The other reason it may look smaller is that it may not have needed a smaller implant in the first place.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

How to tell a capsular contracture

+2

A capsular contracture can range from something fairly minor that can only be felt to being as serious as something that is visibly distorting the breast and painful.   The body takes time to develop a capsule around an implant and if a contracture develops that also takes time, usually at least three months. 

At seven weeks, its too early to tell, swelling may still be a factor.  After the swelling has resolved and and adequate time for healing given, a physical exam is necessary to feel the capsule and determine if contracture is present.   Implant displacement exercises are often recommended by many surgeons to keep the implant mobile on the chest wall and possibly prevent contractures from developing.  If your not doing them, this may help soften them up in the early weeks after surgery.

Mild assymmetries are also expected as there are no two breasts that are exactly the same.  Be assured that 99% of observers besides you are unaware of these differences unless you point them out and the 1% that are aware, probably don't care.

 

Adam Hamawy, MD
Princeton Plastic Surgeon
5.0 out of 5 stars 13 reviews

Capsular breast implant contracture capsulectomy breast implant

+1

Dear Violet,

Seven weeks is too early to tell if you're developed breast implant capsular contracture. I would suggest you consult with your plastic surgeon. I would suggest breast implant massages twice a day and you may want to try some Singulair.

It is true that fluid and hematomas can lead to breast implant capsular contracture. However, swelling and fluid are very common after breast augmentation surgery. Breast swelling usually decreases 6 to 8 weeks after surgery.

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 25 reviews

Capsular Contracture Diagnosis?

+1

It is hard to make this diagnosis in the early stages based on photos.  I would recommend visit with your plastic surgeon.   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.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 35 reviews

Breast Augmentation

+1

This will require an examination and evaluation to determine if there is a contracture or some possible bleeding and tissue density while healing is occurring.  Your Board Certified Plastic Surgeon will be of assistance in determining the cause of the tissue difference.  You still are healing and will need at least 6 months to make a full assessment of the outcome.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 9 reviews

Early capsular contracture after breast augmentation

+1

Seven weeks is fairly early to detect capsular contracture since the implants are usually slightly firm at this point anyway-just from the surgery.  Based on these photos alone it's difficult to say, capsular contracture is something that is felt more than detected on visual exam. I recommend having your plastic surgeon exam you to evaluate your implants. You can massage your implants or try taking oral vitamin E to help soften the implants if you do in fact have capsular contracture.

Best wishes,

Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 141 reviews

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