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I Am Becoming Very Concerned About Capsular Contracture. What Do You Think? (photo)

asked 3 months ago by EasternWA02 in Washington State
Latest answer by York Jay Yates, MD
Question viewed 549 times
Tags: silicone implant, under muscle, 10 months post-op, capsular contracture, high profile

I am 46, 5'4", 118-123. Both 400cc-silicone gel-high profile-unders. Good size for me. From the get go I was high and tight as I had dense peck muscle tissue. I am now 10 months post op and my implants are still high and tight--especially the right. Am I developing capsular contracture? They have not and do not move about freely. I can barely squeeze them together and are hardish when laying on chest. Tips on softening them? Will strapping or laying on them help? Do you think I need surgery?

18 answers to I Am Becoming Very Concerned About Capsular Contracture. What Do You Think? (photo)

This appears to be capsular contracture.

Comparing your 3-month post-op and your 10-month post-op photos shows progression of capsular contracture. This is particularly evident in the last view with hand pressure causing the severe and "sharp" edge visibility. Especially with below the muscle implants, your breasts should be much softer and gradual in appearance, more like your first 2 photos at 3 months. Are you sure your surgeon went below the muscle? Submammary implants are somewhat more likely to develop capsular... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Capsular contracture vs tight implant pocket

You clearly have excess firmness of the capsule around the implant which could be related to: 1) True capsular contracture or 2) A fairly tight capsule from a small pocket formation at the time of surgery. Either way, in my opinion surgery is indicated. Either capsulectomy with new implants for capsular contracture or capsulotomy with rrelease of the capsule inferiorly and laterally and replacement of the same... more

York Jay Yates, MD
Salt Lake City Plastic Surgeon

Capsular Contracture

Unfortunately you have a capsular contracture which is significant scar around the breast implant. The only good option is to re-operate. If on top of the muscle i would place them underneath. Maybe consider a little smaller implants. Medication is a option but best for type 1 and 2 contractures. There are 50 to 60,000 new contractures each year. Common. good luck.

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

www.dr-delgado.com

Capsular contracture vs small pocket

You really need to see a board certified plastic surgeon who can examine you and can tell what is going on with your breasts. Pictures just don't tell the whole story. In my experience implants placed under the muscle tend to ride higher than ones on top of the muscle and high profile ones tend to have a sharpe, less gradual transition between the chest wall and the breast. This is more noticeable with larger implants. So I would be more inclined to think your problem is not a... more

Margaret Skiles, MD
Sacramento Plastic Surgeon

www.featherriverplasticsurgery.com

Implant capsules

Based upon your photos, it looks like you have a capsular contracture that probably needs removal of the capsule and replacement of the implants.

Steven Wallach, MD
Manhattan Plastic Surgeon

Concerned about capsular contracture

It appears that from your progression photos that you are demonstrating some form of capsular tightening. It is possible that some of this was the initial procedure as you describe this, but you do show some degree of progressive tightening. Clearly there is limited movement of the implants as well. The treatment for either is the same with a release of the capsule to allow for the implant to sit more naturally on your chest. Some patients do show improvement... more

Vincent P. Marin, MD
San Diego Plastic Surgeon

www.marinaesthetics.com

Misshapen breast after breast implant and capsular contracture

Your posted photos show implants that appear to be above the muscle (despite your describing them as unders), are centered above the nipples and have a sharply visible edge with flattening of the inner lower quadrant contour on the left. You stated this high tight appearance has been present since surgery rather than developing over time so it is more likely to be inappropriate implant/inadequate pocket than it is capsular contracture. The treatment is the same though: adjustment of the... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

I Am Becoming Very Concerned About Capsular Contracture. What Do You Think?

Thanks for the posted photos. You have a severe capsular fibrosis that needs attention via surgical release. I believe you are submuscular but very hard to tell. Follow up please

Darryl J. Blinski, MD
Miami Plastic Surgeon

Breast implants are high and tight

If the implants have always been high and tight it is more likely that you have problems with the implant pocket and perhaps the implant selection. The HP implant is rounder like a grade I capsule, but your point of projection from the implant is above the nipple. If you like your result you do not need surgery. Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

You have capsular contarcture based on th e3 months and 10 months follow up picture

You results are not acceptable and you will need revision . Your implants seem to be above the muscle and will need to change your pocket position to sub-muscular.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Capsular contracture?

Your photos could either demonstrate capsular contracture or malpositioning of the implant pocket, or both. EIther condition would require a revision. It is best to have an examination with a board certified plastic surgeon to discuss your options. At this point, 10 months after surgery, self-treatment will be of absolutely no benefit.

Robert L. Kraft, MD
New York Plastic Surgeon

I Am Becoming Very Concerned About Capsular Contracture. What Do You Think?

If your implants have always been high and tight and never softened, then it is possible that these pockets were underdissected for these large implants. If they initially softened then became firmer, they represent capsular contractures. It is also possible that capsular contractures can develop early on before a large, tight implant has the opportunity to stretch the tissues, so the change from early relative tightness to capsular contracture can sometimes be difficult to... more

Robert M. Grenley, MD
Seattle Plastic Surgeon

www.seattleplasticsurgery.com

Exam needed..

As you can see from the answers, it is a toss up as to whether this is a pocket issue or capsular contracture. As others have noted, the only real way to tell is to have an exam by your plastic surgeon. I agree that surgery will be necessary to correct either issue. Good Luck!

Brian Klink, MD
Sacramento Plastic Surgeon

Bilateral symmetrical capsular contractures are rare

It would be less common for you to have equal and symmetrical cc that to just have had implant pockets that need widening and lowering. If the have always beed hard and tight this lessens the potential that this is cc and more just pocket issues. Either way, you will need surgery to improve the situation.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Concerned About Capsular Contracture

Dear EasternWA02, While your history and your photos demonstrate that you may have developed a capsular contracture in both breasts, it is also possible that your tightness is the result of a pocket that may be too small for the implant size selected. This can also result in the implant being positioned too high in the breast which appears to be the situation in your photos. The only way to determine exactly what is occurring is to have a consultation with a plastic... more

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon

Capsular contracture can sometime be diagnosed in photos

Your photographs and history are very suspcious for capsular contractures. To confirm the diagnosis would require an examination of your breasts. I'm sure your plastic surgeon would be very interested to know of your condition. If he or she is not available, any board certified plastic surgery should be able to make the diagnosis. Although treatment does not always require surgery, at this late date I suspect that the non-surgical options would not be successful. Good luck... more

Wayne I. Yamahata, MD
Sacramento Plastic Surgeon

www.anuyu.com

Capsular contracture is a possibility

Looking at your pictures it is very possible that you have capsular contracture. It is also possible that your breast pockets have never been made large enough to accommodate your implants fully and remain tight (instead of becoming tight as in capsular contracture). Best thing would be to see your plastic surgeon who has seen you previously and knows what was done during the surgery and what your recovery was like. Sincerely, Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon

www.torontosurgery.ca

Concerned about capsular contracture

Based on your photos #3 and #4, it seems like you do have capsular contracture. Are the the implants getting firm/hard? There are different degrees of capsular contracture. When you develop grade III or grade IV capsular contracture, I would recommend you to exchange the implants and to undergo capsulectomy. You should go back to your plastic surgeon to be examined and to discuss the options. After 10 months postop, the implants will not further drop down or get... more