I had breast augmentation six months ago (end of Feb) and had capsular on the right side of my breast. My doc told me he would give me a revision but I'm not sure if I should do a revision or continue with proper massage? What is the success rate? Is it advisable to do revision so soon? And what are the pros and cons? Would like to get a second opinion from the doctors here. Would greatly appreciate any advise you could give. Thank you so much.
Is Six Months Too Soon for Revision? (photo)
Doctor Answers 3
Hard to know ideal timing but 6 months seems reasonable enough
Thank you for your photo. Six months should be ample time to make an educated decision about revision surgery for this type of breast issue. I would encourage you to have all of the capsule removed, implant replaced, possibly a drain for 2-3 days, and aggressive massage +/- singulair afterwards.
All the best,
Dr Remus Repta
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Timing of revisions in breast augmentation
From the picture it looks like the left breast has the contracture but sometimes the diagnosis is unclear, not to mention the cause.
In general, 2-3 months minimum is needed to allow the tissues to recover before a revision. After that, the answer is to follow and make sure the process is stable and is no longer changing. In the case of true capsular contracture (thought to be caused by low-grade bacteria or some irritant of the capsule), the process needs to be quite stable before considering a revision and even then there is a wide difference of opinion on what is the best approach. Simple malposition of the implant or capsule/implant discrepancy in size can be corrected with a capsulotomy procedure but if bacteria or ongoing irritation is suspected then the implant should be replaced and consideration should be given to removing the previous capsule and replacing at least part of it with a dermal matrix graft which acts like a capsule but can't contract. Unfortunately there is no reliable test to determine what is going on or what is the best surgical revision or when to intervene.
Is Six Months Too Soon for Revision?
Check with your surgeon to ascertain that you have tried or at least considered all the non-operative options. Massage is one, anti-inflammatories another (vitamin e, motrin), and the asthma medicine Singulair has worked for some women. If you have done these or choose not to, 6 months is probably long enough.
There will be many considerations for treatment at surgery
- Position change?
- Implant change?
- Use of acellular dermal matrix (Strattice)
- Full removal of the capsule?
Each has pros and cons. Success rate is said to be highest with Strattice, but it is pricey.
Thanks for the question, best wishes.