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What Are my Options for Correcting Capsular Contracture for the Third Time?

I have Saline breast implants submuscular. I have a capsular contracture on my right side for the second time. I have taken all the necessary steps in preventing CC both times (massaging, vitamin e, singular) my initial surgery was September 1st 2010. Then the corrective surgery June 16th 2011, I know it will need to be removed and corrected yet again. Any advice on what I can to do prevent another capsular contracture? Perhaps I should go bigger or different implants???

Doctor Answers (11)

Breast Revision

+1

You need to consult with a Board Certified Plastic Surgeon and evaluate the options.  Vitamin E is likely doing nothing for you, and the option of going bigger will increase your risks.  After being evaluated by a Board Certified Plastic Surgeon, they will give you all your options, even the option of doing an explant only and waiting for a time period before considering another implant.

Web reference: http://www.facebook.com/elitemdspa

Danville Plastic Surgeon
5.0 out of 5 stars 9 reviews

What are my options for correcting Capsular Contracture for the third time?

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I have found tremenous success using Strattice alone with partial capsulectomies in my patients. Strattice is a xenograft made from the skin of pigs. It is essentially medical grade very thick dermis from skin. You are already under the muscle so the contracture typically comes from contact between the implant and your breast tissue.  I typically remove the capsule below the muscle and suture the Strattice to the crease and muscle thus providing for full implant coverage.  This will likely give you the best chance of keeping your implants and having a satisfactory result. Good Luck!

Web reference: http://stlcosmeticsurgery.com/

Saint Louis Plastic Surgeon
5.0 out of 5 stars 61 reviews

Steps to preventing a recurrent capsular contracture.

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Recurrent capsular contracture is a difficult problem to correct. Options include total capsulectomy (removal of the entire capsule), site change of the implants, and the use of a dermal matrix such as Strattice. Dermal matrices have been shown to decrease capsular contracture rates significantly. The dermal matrix is typically placed along the lower pole of the implant, much like an internal bra. While your body will develop a capsule in every area which comes in contact with the implant, it will not create a capsule where the dermal matrix is located. In theory, it is the lack of continuous capsule around the implant which prevents the recurrence of a contracture. However, the drawback is the cost - dermal matrices can cost several thousand dollars. Of course, prevention of another surgery for capsular contracture will save you much more money in the long run! Other advantages include less visible rippling (due to increased tissue thickness), and better support of the implant over time.

Web reference: http://www.drbogue.com

Boca Raton Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast Implant Revision - What Are my Options for Correcting Capsular Contracture for the Third Time?

+1

Hi,

The question is whether you want to (1) remove them and forget the whole thing, (2) try one of the options that have been suggested so far or (3) give it one more try and go all-out.

I would probably suggest option #1 or option #3.  What doesn't sense is to try one, relatively small change (ie, such as switching to textured implants).  That's okay for a second procedure but since you're already had a second procedure and developed a capsule almost immediately, I think you need a more substantial procedure.

So, if you're going to keep your implants (option #1 remains removing them altogether - though that has its own problems, including loss of volume and what to do with any excess skin) I would probably advise that you undergo a capsulectomy (total or partial), insertion of an acellular dermal matrix (such as Alloderm or Strattice - the early results with these materials are generally impressive) AND possibly a textured implant.  It simply doesn't make any sense to go through a third operation just to make a relatively small change.

I hope that this helps, and good luck,

Dr. E

Web reference: http://www.bodysculpture.com

New York Plastic Surgeon
5.0 out of 5 stars 140 reviews

Recurrent capsular contracture treatment

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In cases as you have described, I have been impressed that capsulectomy and Strattice have to date always resolved the contracture issues in my practice. The other option is just remove the implants altogether. I am not convinced that texturing or the filling material makes much of a difference( gel vs saline). Sorry for your frustrating experience. Good luck
Tyler Plastic Surgeon
5.0 out of 5 stars 2 reviews

Recurrent capsular contracture

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Saline implants tend to be firm, which can predispose to tight capsules.  Complete capsule release, exchange to silicone gel implants, and the placement of a membrane "patch" may help.  Biologic membranes that your body ultimately replaces with your own tissue have been shown to prevent capsular tightening.

Tampa Plastic Surgeon
5.0 out of 5 stars 11 reviews

What Are my Options for Correcting Capsular Contracture for the Third Time?

+1

Maybe you are a scar former in your genetic history? You could try textured implants, though the ripples are bothersome. Change the location of the implants from submuscular to sub glandular. Or try Enriched PRP fat grafts to the breasts, size is a limitation though. 

Miami Plastic Surgeon
4.5 out of 5 stars 55 reviews

Capsular contracture a third time

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Capsular contracture though infrequent is very frustrating, and after a first attempt at opening the capsule there are some options which remain. A textured highly cohesive implant might be an available option. Another is replacement of the implant into a subglandular pocket to give it a new start. Third is placement of an acellular dermal implant (Strattice) to disrupt the capsule formation.

Best of luck,

peterejohnsonmd

Web reference: http://www.peterejohnsonmd.com

Chicago Plastic Surgeon
4.0 out of 5 stars 25 reviews

You may benefit from taking the implants out and leave them out for three months

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Your picture and more information about the site of insertion would help. For the patients that have multiple capsular contracture, implant removal and letting tissue to heal can be an option. The other option that I offer my patients is implant removal and fat grafting. You may visit my web site for the example of implant removal and fat grafting.

New Orleans Plastic Surgeon
5.0 out of 5 stars 46 reviews

Strattice for recurrent capsular contracture

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In my experience, the most reliable way to prevent a capsular contracture after it has already recurred is with the use of an acellular dermal matrix graft such as Strattice. Massage has never been proven to make a difference in contracture, and results from singulair are highly variable. The disadvantage of Strattice is that it is a bit expensive, but compare the costs to expenses of more surgery later. In any case, the implants shoud be replaced also and the capsule should be removed.

Seattle Plastic Surgeon
4.5 out of 5 stars 21 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.

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