Concerns About Downsizing and Reoccuring Capsular Contracture?

I had 700 cc memory gel implants put in 4 months ago along with a tummy tuck and lipo on my arms, thighs, stomach , lower back and butt. Everything healed fine, but now I have developed capsular contraction in my right breast. II am getting it replaced on July 10 , and since I am already going in for surgery I was thinking about going down a couple of sizes. I am concerned that since I already got cc once, what if it keeps happening, and how will my skin bounce back?

Doctor Answers (4)

Capsular contracture

+1

There is always a risk that if you had a capsular contracture that it may occur again. Some surgeons will opt to use Strattice with the thought that the capsular contracture rate is low with the product, but it is quite expensive.


Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Preventing Capsular Contracture Recurrence

+1

There is a higher rate of contracture after you've had one. Since we believe that there is a subclinical (in other words, not a symptomatic) infection, or at least a colonization of the capsule that causes the tightening to occur, I remove the capsule and put in a new implant. This minimizes the likelihood of recurrence. I find that the harmonic scalpel, which uses ultrasonic energy to cut, to be particularly useful in this surgery, as it allows for the least amount of disturbance of the surrounding normal tissues.

Going smaller at the same time is a good idea, but shouldn't have any effect on recurrence.

 

 

Verne Weisberg, MD
Portland Plastic Surgeon
5.0 out of 5 stars 6 reviews

Recurrent caosular contracture

+1

Once a patient has had a capsular contracture ,there is a high rate of recurrence if the implants are simply replaced.

Today we are more familiar with the causes of capsular contracture and how to reduce the risk of recurrence

The following are some of the factors that need to be considered

Implant type ,Gel ,Saline or Adjustable saline with the option if  temporary overexpansion of the capsule following release

Capsulectomy v/s capsulotomy .Placement of acellular dermis or absorbable mesh

Implant placement  Sub glandular,submuscular or subfascial

Strict aseptic technique ,avoidance of powered gloves

Use of and placement of drains

Antibiotic ,antiseptic irrigation 

Post operative antibiotics, ultrasound,Massage avoidance of smoking and medications that cause bleeding

There is conflicting evidence that textured implants have a lower incidence of capsular contracture

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 6 reviews

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Capsular Cotractures

+1

I believe that CC are a result of a low grade infection.  In that case you need to have the capsule removed totally if possible. Releasing the capsule has a very high rate of recurrence.  Downsizing the implant should have little to do with the risk of recurrence but if you are too big then now is the time to change the implants out as it will save your money and time. 

 

The risk of getting another CC is in the neighborhood of 4% if your remove the entire scar capsule.

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 10 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.