How Long to Wait Before Fixing Capsular Contracture?

Hello, I had my first breast augmentation on July 7th this year with smooth silicone implants under the muscle. My left breast started contracting in week 7 and now at my 3 month post-op my surgeon recommending replacing the implant and using Strattice this time. I am only wondering if my breast is now inflamed and contracting, would it be better to wait a few more months for the inflammation to go down before doing the surgery, so that the current inflammation doesn't affect the outcome?

Doctor Answers (11)

How long to wait for capsular contracture surgery

+3

Statistically about 80% of women who get capsular contracture will develop it in the first two years and in my personal experience the vast majority of those will develop contracture in the first 2 to 6 months. There is no exact science as to when is the optimal time to perform a capsulectomy but I would probably wait until the process has stopped for about a month. In other words once the contracture is no longer getting worse or changing, then wait 4 to 6 weeks before having the capsulectomy performed. I personally wouldn’t use Strattice for the first episode of capsular contracture. I’ve only had one capsulectomy redevelop contracture; so the odds of getting a resolution to the capsular contracture without the use of ADM (acellular dermal matrix) are quite good.  I would avoid the extra expense for something that probably is not necessary and that doesn’t guarantee that contracture won’t recur. If someone has had multiple recurrent contractures then ADM would be a very reasonable option.


Nashville Plastic Surgeon
4.0 out of 5 stars 10 reviews

Wait for 6 months, and replace with polyurethane covered implant

+3

Dear lady, I agree with our other colleagues that a 6 months cooling down period is recommendable. However, I am afraid that the chances of recurrence of capsular contracture are high. I know that they are not available anymore in the USA, but we have been using MicroPolyUrethane covered silicone implants for over 10 years, and the chances of recurrence of a capsular contracture with these implants is ten times lower than with any other implant. The quality of the result is also at least as good as with any other silicone implant, if not better.

 

Alexis Verpaele, MD
Belgium Plastic Surgeon

Plastic surgery is one of the few areas where you "do not do today"

+2

what you can honorably postpone until tomorrow...this is because so much of the final results in plastic surgery depend upon formation and remodelling of scar tissue.  This includes all of the scar tissue you do not see, under the skin.   And just like the scar you see on your skin which tends to become less visible with time,  the scar tissue under the skin is also softening and thinning out (usually).  So if there is pain from the contracture, then operating early is often necessary, but in general it is preferable to wait 6 to 12 months, and sometimes find that no surgery is necessary at all!   Good luck to you.

Eleanor J. Barone, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 4 reviews

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When to operate on capsular contracture.

+2

There is no hard and fast rule on when to operate to correct capsular contracture. Most surgeons will likely wait a minimum of 3 months. The reason for waiting is to allow for resolution of swelling, inflammation, and often times to give non-operative options a chance to work (aggressive massage, U/S therapy, etc.) However, every patient is different and correction is usually individualized. The use of Strattice is a good option for prevention of recurrence.

David Bogue, MD
Boca Raton Plastic Surgeon
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Capsule post aug

+2

I would probably wait a while.Exercise the pockets with massage and soem say ultrasound may help.soem surgeons may try singular to help soften a new capsule but I would probably wait a bit longer.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 18 reviews

How Long to Wait Before Fixing Capsular Contracture?

+2

Each case has it;s own individual issues. rule of thumb is to wait 4 to 6 months before revision in my private practice. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Breast augment, capsular contracture

+2

Capsular contracture can  occur anytime and it's a good idea to defer releasing it until you and your surgeon have determined that the process has stabilized. I have had good results using a drug called Accolate for early contractures. You might ask your surgeon about it. Also, you didn't mention the incision site. If it is axillaty, sometimes all that is needed is further release of the lower edge of the pectoralis muscle. And finally, I'd be sure Strattice is necessary. It is quite costly and I have never found it necessary in my patients needing a capsular release. You might want to get more than one opinion.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Capsular Contracture Following Breast Augmnentation

+2

It has been my experience that waiting 6 to 12 months following the initial surgery allows some of the swelling to resolve and the tissues are easier to work with.  In some cases the capsule will even relax adn the breast will soften.  If the capsule is painful and inhibiting your activities it may be reasonable to proceed with a capsulectomy before 6 months time.  Every situation is unique and requires some thoughtful planning.  I would echo the other surgeons thoughts as well.  Best of luck.

Charles Perry, MD
Sacramento Plastic Surgeon
4.5 out of 5 stars 14 reviews

Wait for capsular contracture repair

+2

Capsular contracture after breast augmentation usually takes several months to 'set in' and can be a bit dynamic or changeable. Capsules are graded from one to four and can progress, or can become stable. We fell it best to wait six to twelve months unless the capsule is very firm and uncomfortable. You are right in that the inflammation is active and there is no urgency to the repair.

Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

When to undergo revision surgery

+2

It normally take 2-3 months for the implants to settle down.  By the third month, I do not think that your implant positioning nor capsular contracture will further improve. However, I normally wait 6 months prior to performing revision surgeries.

Sugene Kim, MD
Houston Plastic Surgeon
4.5 out of 5 stars 38 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.