Grade 2 Capsular Contracture - Implant Replacement Not Necessary?

I had 400cc silicone gel implants placed above the muscle a little over a year ago and recently noticed a hardening/tender left breast. I went for a follow up with my PS and he would like to repair this "grade 2" CC. He states it is not necessary to replace the implant, is this safe practice? It makes me feel like I am being set up for yet another CC. Also,I was never instructed to massage/use commpression postop,common? Could it have contributed to my problem? Is it too late to try Singulair?

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5 Doctor Answers | Asked by crna2b in Texas

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Treatment of Grade 2 breast implant augmentation capsular contracture

The anecdotal reports of leukotriene esterase inhibitors were predominanlty reported with Accolate (twice a day) but the convenience of Singluair makes this more popular. However, these reports stated that it was most effective in the first 6 months of treatment. While the idea of a new implant will treat the concept of a biofilm, it is not the standard or universally practiced. Open capsulotomy may be the intial approach.

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Capsular Contracture After One Year

If your one breast is harder, painful or different in shape than your other breast then capsulotomy or even total capsulectomy would be my treatment of choice. Singulair has not been shown to be effective at this late date nor would massage be of benefit.. I would not replace your implant and with the implants being on top of the muscle capsulectomy is usually not much more difficult than capsulotomy.

Capsular contracture

If you have a grade II capsule with some firmness around the implant and I am assuming an asymmetry to the other side, it is reasonable to keep that same implant. But you are at tisk in general for a recurrence.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Implants do not need to be replaced in capsular contracture

When treating capsular contracture, it is not essential to replace the implants. Sometimes patients want to changed the size or the type of the implant at the same time and this can be done. But that is not relevant to the treatment of capsular contracture itself. You are not being set up for another CC. Unfortunately nobody really knows what causes capsular contracture, and there is no test we can offer our patients to predict to whom this will happen, and if it... more

Treatment of capsular contracture

Hi, From your description, it doesn't sound as though have have a Grade 2 capsular contracture. This is the grading system for capsular contracture (Baker score): Grade 1 - The breast is soft, and looks natural. This is pretty close to normal for all breast implant patients. Grade II - The breast is a little firm, but appears natural. Grade III - The breast is firm, and is begins to appear distorted. Grade IV - The breast is hard and painful, and has become quite... more