Since my breast never dropped after my 1st surgery, I had a full capsulectomy and they replaced my 350cc under the muscles with 400cc Siltex textured also under TM. I had heavy bleeding during surgery so they put drains in for 7 days and said there was just a small hematoma left. Now at 6 wks my breast looks almost as it did before surgery, very high and with a saggy bottom and side. My ps wants to see me in 1 month and said to massage but I'm scared I will be forced to have another surgery.
Why Are My Breasts Still Very High After Full Capsulectomy? (photo)
Doctor Answers 6
Upper fullness after capsulectomy probably means probably more than just an implant in the pocket.
From the projection you appear to have from the profile shot, it looks like there is more than an implant in your pocket......hematoma or seroma most probably. A drain won't usually prevent a hematoma if the pocket is not dry at the end of surgery from my experience. You need to be re-explored at the least unless you are first checked with ultrasound or CT/MRI. Leaving blood in there will almost guarantee a hard capsule because blood in the tissue is irritating and stimulates more scar formation. A seroma will keep the pocket stretched out.
Breast implants still too high
At six weeks post-op, it's still early and your implants may still settle into a more natural position. Unfortunately, you may have developed capsular contracture again which will have to be treated with surgery. You could also discuss the use of Accolade with your plastic surgeon. It's a medication that has been beneficial in some cases if early contracture. Hematomas have been linked to capsular contracture, but it's hard to draw a completely linear relationship.
Untreated hematoma increases the incidence of capsular contracture.
One of the predisposing factors capsular contracture is in inadequately treated hematoma. It's possible that if the hematoma after capsulectomy was inadequately treated it might increase the risk for a recurrent capsular contracture.
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Hematoma after surgery
How does your surgeon know there is a little hematoma? If it was based on physical exam, an ultrasound might be helpful to look at the space around the implant. If there is a lot of blood or fluid, then it will need to be drained. Wearing a bandeau strap might help the implant settle slightly, but it may very well require further intervention to be symmetric with the other side.
Without an exam it is difficult to say. Do you still have blood around the implant? Is there a seroma? Is it muscle spasm?
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