Should I have a capsulectomy, capsulotomy, or just continue massaging? (photo)

Hello,I am sorry about your capsular contracture of your right breast. With all do respect to your experience, lasers, straps, massage, and ultrasound have never been shown to be effective in either prevention or treatment of capsular contracture in clinical studies.  In other words, your left breast would have softened had you done nothing to it.  I've not asked a patient to massage in over 10 years, yet my rate of capsular contracture has fallen - not because of the lack of massage, but because of other things that have changed as well.Singulair has had lackluster results when examined in clinical trials. It fails statistical significance in most studies, however a few showed modest efficacy.  In practice, Singulair, when it actually worked, managed to only soften a breast, never could it drop it back into its proper position.I do not recommend either closed or open capsulotomy.  You will be at high risk for recurrence. I do not recommend using expensive ADMs like Strattice or Alloderm, they are usually unnecessary.  In all likelihood, you will be completely cured with a total capsulectomy and replacement with a new implant.  It is a more time consuming and technically difficult surgery to perform well, but it is well worth it!Best of luck!

One of the most common problems is breast capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant. Nicotine users, such as smokers, have up to a 30x increased risk of #capsular contracture.

Saline implants may deflate spontaneously. When the patient has significant #symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is r#ecommended to ensure adequate pocket dimensions.

New implants may then be placed in the same existing position or may undergo a change of #placement frequently from submammary to subpectoral position and, on occasion, the other way around.

Saline implants under the muscle rarely develop significant capsular contracture.  Often, saline implants may feel too hard if overfilled too much or if the space was not made large enough.  Only an in person exam would determine if that is the case in your situation in which case the correction is simple.  Laser is a waste of time.