Can Capsular Contracture Be Fixed with Smaller Implants and a Skin Graft?

I'm suffering from pain due to capsular contracture in one breast. I've had 2 surgeries already-1st implants were saline, 2nd are silicone gummies. It's been 1.5 years since my last surgery and I've been to see my surgeon with concerns. He says I need to continue massaging it and see how it is in another 12 months. I'm not satisfied with that answer and would like to know what the possibility is of replacing them with smaller implants and using skin grafting on the outer layer of implant? Is there a certified plastic surgeon who can fix my capsular contracture?

Doctor Answers (7)

Can capsular contracture be fixed with a smaller implant and a skin graft?

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Hello! Thank you for your question! Recurrent capsular contracture is a very difficult problem. Assuming you tried conservative measures in the past - implant massage and may add the medication Singulair and Vitamin E. If these fail, surgical correction may be necessary. It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. Irrigating with certain medications may also be if benefit. Some other things that may have been tried include changing the position of your implant, addition of a dermal matrix, or consideration for the the shaped, textured, anatomical gel implants.

Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. At a 3rd recurrence, it may continue to occur despite all of these modalities and consideration for explantation or living with the contracture are options. Hope that this helps! Best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Can Capsular Contracture Be Fixed with Smaller Implants and a Skin Graft?

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 Sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.  In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix.  Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source ( human, porcine, or bovine in origin).  I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 751 reviews

Can Capsular Contracture Be Fixed with Smaller Implants and a Skin Graft?

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Skin grafts are not an acceptable form of treatment for capsular contracture but use of cadaveric skin within the implant pocket called Acellular Dermal Matrix has been reported to be associated with a lower risk but can be as costly as the implants.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

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Capsular contracture and repair

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A capsular contracture can be corrected by removing all or some of the capsule, perhaps changing the pocket or using a different type of implants, and there are some recommending not a skin graft but using alloderm which is a type of skin from cadaver.

Steven Wallach, MD
Manhattan Plastic Surgeon
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Correcting recurrent Breast Implant Scarring (Capsular Contracture) is Very Challenging

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Regarding - "I'm suffering from pain due to capsular contracture in one breast. I've had 2 surgeries already-1st implants were saline, 2nd are silicone gummies. It's been 1.5 years since my last surgery ... would like to know what the possibility is of replacing them with smaller implants and using skin grafting on the outer layer of implant?"

It sounds like you have the worst form of breast implant scarring (capsular contracture) - Baker IV class (painful scar). The problem is that thee is no one sure way of correcting severe capsular contracture except for removing the implants. Ordinarily the options would be : cutting through the scar and releasing it (Capsulotomy), removing the scar (Capsulectomy) in pert or fully or removing the implants. There is evidence that removing the scar tissue and replacing it with a skin matrix (Alloderm, Strattice) delays or stops the recurrence of the process. None of these reports are long enough to be convincing much less scientificially valid.

Peter A. Aldea, MD
Memphis Plastic Surgeon
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Smaller implants will not help.

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I would suggest to remove the implants and wait 3-6 months and then try either new set of implants or fat grafting. I have done more than 50 patients that were tired of implants and had multiple surgeries. I have removed their implants and performed fat grafting . You can check my web site for pictures.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
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Surgical Correction of Capsular Contracture

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Some cases of capsular contracture are very difficult to correct such as yours.  Rather than a skin graft which cannot be burried beneath the skin, you might benefit from incorporated a dermal matrix (such as AlloDerm) into the capsule.  However, the cost of the product is significant.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

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.