9 months post op, malposition or capsular contracture? (photo)

I am 9 months post op and about a month and a half ago I noticed my left implant about an inch higher then my right. The bottom has looser skin and I noticed small bands when I raise my arms in the crease where the insition was made. It is not hard or firm and moves around in the pocket. There is no knots and it does not hurt. I feel alittle mucles soreness when I sleep but thats it. My implants are 375cc hp under the muscle. Any idea what this could be?

Doctor Answers 9


You need to be examined in person to see what the problem is.  Pre-op photos would also be helpful.  Please see your PS.

Toronto Plastic Surgeon
5.0 out of 5 stars 31 reviews

199 Avenue Road
Toronto, ON M5R 2J3

Asymmetry of breasts

It is always a good idea to post pre-op photos. You have asymmetry now and most likely had it before. This would help establish what could be beneficial for you in the future.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

9 months post op, malposition or capsular contracture?

No before photo posted! So a comparison of the asymmetry you had cannot be seen... That is your issue.. To me your result is very good..//

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 77 reviews

6330 Manor Lane
Miami, FL 33143

Malposition or capsular contracture?

Based on your photo and description, you could have either a malposition or capsular contracture. A capsular contracture would tend to make the implant feel more firm than the other side and an implant malposition would not. Capsular contractures tend to get worse with time. Either way, you will probably need another surgical procedure to obtain some better symmetry.

William T. Stoeckel, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 64 reviews

300 Keisler Drive
Cary, NC 27518

Implant shift

The most common cause of this change would be a capsular contracture although the implant would typically also be firm. Best to return to your PS.

Christopher J. Davidson, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 22 reviews

332 Washington St
Wellesley Hills, MA 02481

Breast asymmetry

You should discuss with your original surgeon. You should review your preoperative photos to look at pre existing asymmetry. Your description would not be indicative of a typical capsular contracture (HARDENING). There are many causes of malposition which should be discussed at visit with your plastic surgeon.

Terrence Higgins, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 3 reviews

8530 West Sunset
Las Vegas, NV 89113

Change in position of a breast implant after 9 months may be capsular contracture

Thank you for your question and photograph. I agree it is impossible without an exam and understand what is happening to you.

However elevation and change of position of an implant after 9 months is most commonly caused by a capsular contracture although you say you're implant is not firm.

Please make an appointment to be examined by your plastic surgeon so a proper diagnosis can be made

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 65 reviews

195 Commonwealth Avenue
Boston, MA 02116

Breast Implants Change Over Time

There are three changes that can occur with breast implants over time, leading to asymmetry. These include: drooping ("bottoming out"), capsular contracture, and implant rupture. "Bottoming out" of the implants occur due to pressure of the implant on the breast fold. In some cases, the breast fold may become so disrupted that the implant ends up on the abdomen. Capsular contracture can occur for a variety of reasons, a common possibility being low grade bacterial colonization of the implant. Implant rupture (or "silent" rupture) can occur with silicone implants, also leading to asymmetry.

Of course, several of these issues may occur simultaneously. It may be that the right side has mild bottoming out of the implant, while the left side has a mild capsular contracture (Baker grade II). Taken together, this could contribute to the minor, but noticeable asymmetry. Speak to your plastic surgeon and obtain a second opinion, again from a board certified plastic surgeon. It would not be unreasonable to obtain imaging studies (e.g. MRI) to evaluate the structure of the implants.

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 93 reviews

220 E Central Pkwy
Orlando, FL 32701

9 months post op, malposition or capsular contracture?

Thanks for your question and the attached photo.

What is apparent is the asymmetry. What is not is the cause. Without seeing before photos, no one can say that this is not the result of asymmetry before surgery. Asymmetry is usually more apparent in larger breasts.

You mention two other possibilities. If both implants are soft and equally so, it would not be capsular contracture. That would leave malposition as an explanation, but of course that is just a description, not a cause.

Discuss options with your surgeon. All the best.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 40 reviews

1110 112th Avenue NE
Bellevue, WA 98004

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.