Possible Capsule Contracture, Would Like More Info

After 9 years, having problems with hardening of left breast. There was more saline place on that side.Right Breast feels normal, but now it is sagging compared to left breast. After my surgery,the Dr. told me at my follow up that I would need to wear underwire bras to maintain them because I had more elasticity in my skin and that was why my left breast was firmer. I was disappointed, but have worn sports bras to bed the last 9 years and underwires. I had the surgery to keep from that to start. What to do?

Doctor Answers (6)

Possible capsular contracture

+1

Capsular contracture involves scarring and tightening around the implant, causing the breast to feel firm and sometimes look abnormally round or elevated. It is associated with pain as well. This can sometimes be treated without surgery, but if the problem persists, may require another operation. Please see your surgeon as soon as you can for an evaluation. Best of luck.


Toronto Plastic Surgeon
5.0 out of 5 stars 70 reviews

Capsular Contracture

+1

After 9 years, it sounds like you have developed capsular contracture around your implant.  The rate of contracture varies from surgeon to surgeon, but at about ten years, the overall contracture rate is probably between 5-10% of all implants.  Sometimes this is easy to correct by simply removing scar tissue.  Other times, this also requires changing the implant and the position of the implant as well.  The best thing to do is to see a board certified plastic surgeon and see what they have to say.  They can give you an accurate idea of what may be going on and what may be necessary to fix it.  I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.5 out of 5 stars 27 reviews

Proper evaluation is required to diagnose capsular contracture.

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Sorry to hear that you have had this problem for 9 years. That is quite a long time to simply "live with it." Hardness of a breast implant following augmentation is most often related to capsular contracture. This process usually does not improve without intervention. To properly diagnose what is going on, you need to see a Board Certified Plastic Surgeon. However, at this point, surgery is likely going to be your best and most reliable option for correction if it is a true capsular contracture.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

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Capsular Contracture

+1

I recommend consulting a board certified plastic surgeon to discuss possible revisionary breast surgery. After breast augmentation surgery excessive scar tissue may form around the breast implant which causes the breast implants to harden (similar to what a contracted muscle feels like). The cause of capsular contracture is unknown, but it is the most common complication with breast augmentation surgery and may be a painful burden for some patients. There are different grades of capsular contracture ranging from mild to severe. By placing the breast implants below the muscle (sub-muscular), the rate of capsular contracture has significantly decreased. Also, it is said that massaging of the implants helps decrease the chance of capsular contracture. Correction involves removing the scar tissue that is encapsulating the implant and releasing the tension around the implant.
You may also benefit from mastopexy surgery if the breast tissue has moved down in relation to the breast implant. You should be examined by a qualified board certified plastic surgeon to evaluate your situation.

On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.
 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Possible Capsular Contracture

+1

Capsular contracture can occur after breast augmentation. Your body will normally create a scar, or capsule, around your breast implants. Most of the time these capsuled don't cause any problems. Sometimes, for a variety of reasons, the capsule can start to get smaller, or contract. This can result in a change in the way the implant appears. Sometimes there is pain involved. Sometimes the implant will fail, or rupture. 

The best way to determine this is through a face-to-face consulatation with a board certified plastic surgeon. Also being in the Jacksonville area I would be happy to evaluate you. 

William A. Wallace, MD, FACS
Jacksonville Plastic Surgeon
5.0 out of 5 stars 20 reviews

Breast Implants - Possible Capsule Contracture, Would Like More Info

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Hi Pooh,

It's difficult to make an assessment without seeing photos and, even more, without being able to examine you in person.  However, overfilling a saline implant (compared with less saline in the same size implant on the other side) typically leads to an implant that is relatively firmer and, often, higher-sitting.  So it's not surprising, based on what you say, that the softer one was not only softer but has sagged a bit.

The firmness on the left may be due as much to the overfilling as to a capsule - but you may also have both.  You'll need to be seen in person but a complete repair of this may include replacing one or both implants and, as needed at the time of the surgery, removal or release of some or all of the scar tissue on the left side.  New implants can be placed at that time, or just the one on the left if you want to do only that one.  And if there's too much sagging on the right (nothing personal, of course) you may want to have a small lift, or larger implants on both sides.

In general, I advise against filling similar sized implants with different amounts of saline since I think it leads exactly to this - a difference in the way the implants look and feel.  If different sizes are advisable, I usually recommend different size implants, with each filled to the same PROPORTION, in order to maintain a consistent look and feel.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 155 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.