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Am I Suffering from Capsular Contracture, Can I Do Anything to Aide Healing, Will I Need Another Surgery? (photo)

asked 5 months ago by BBLange in Sacramento
Latest answer by Jacob Freiman, MD
Question viewed 1,065 times
Tags: silicone implant, under muscle, 2 months post-op, capsular contracture, hard, uneven

7 weeks out from under the muscle, silicone implants. I had bleeding in my left breast the night of surgery, had 2nd surgery & a drain put in. That breast has healed perfectly. Dropped & softened within 3 weeks. Now my right breast is higher, its not really firm, I do feel a lot more hard knots/lumps including under the incision on right breast. I have a flat spot on the bottom of nipple along incision. When I flex it dents in. I am receiving ultrasound massage twice a week. I've done 3 so far.

16 answers to Am I Suffering from Capsular Contracture, Can I Do Anything to Aide Healing, Will I Need Another Surgery? (photo)

Capsular Contracture and Breast Augmentation

It is impossible to say whether this is an early capsular contracture without an examination but based on the photo it looks more like the sub-areolar scar has healed to the deep tissues. Massage usually helps this but if it does not resolve a minor procedure to free the scar tissue can help. The other issue is the fact that the right implant is higher than the left which may be caused by a higher inframammary fold on that side. Early-on it may settle with taping and massage but if it is... more

Jacob Freiman, MD
Miami Beach Plastic Surgeon

Am I Suffering from Capsular Contracture, Can I Do Anything to Aide Healing, Will I Need Another Surgery?

For now I would massage very aggressively....it is most likely early scar tissue that is stuck to the incision and not capsular contracture. It can be common with the areolar incision.....Give it plenty of time and plenty of massage!!!!

John J. Corey, MD
Phoenix Plastic Surgeon

Breast augmentation issues

The puckering may be from scar tissue that developed upon healing. Sometimes massage helps sometimes time helps to soften it. As for a potential capsule, it is hard to say without can exam, but it is still early.

Steven Wallach, MD
Manhattan Plastic Surgeon

Misshapen breast after breast implant and capsular contracture

Your posted photos show some asymmetry with the left implant and nipple slightly lower than the right. I believe this is an early capsular contracture. Your body formed more scar on the right and the scar between the skin and muscle is contiguous. If the massage does not work you will need revision surgery. Deep massage like endermology can work wonders in these situations. You are doing the right thing by continuing to follow up with your surgeon and he/she is doing the right thing by not... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Capsular contracture after surgery

You may need a revision procedure. I highly recommend you see your surgeon regarding the dimpling at areola.

Jeffrey Hartog, MD
Orlando Plastic Surgeon

Revision after breast augmentation

Aggressive massage and ultrasound may improve the dimpling at the areolar incision site but that area is notorious for retracting scars (due to scarred ducts). It is also common for under-the-muscle implants to stay separated from native breast tissue (by the muscle layer) which can lead to a "double bubble" contour. In this latter case a revision is needed to release the capsule to allow the implant to flow into the breast (instead of being isolated by the muscle... more

Daniel Greenwald, MD
Tampa Plastic Surgeon

Am I Suffering from Capsular Contracture, Can I Do Anything to Aide Healing, Will I Need Another Surgery? (photo)

Even with the posted photos it would be a guess if you need revisional surgery. But it is a real option after 3 months of healing.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Capsular contraction is alway a problem.

Early capsular contracture occurs more than is reported. The breast may soften and drop over time. Message, vit E and possible accolate may all be helpful. I would not go back nearly this soon at all your photos look good for the issues that you have had.. If it becomes uncomfotable, painful or not attractiuve,then, i would advise doing something, Remember, you have these for a lifetime and you will need to deal with some issues.

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

www.dr-delgado.com

Early Capsular Contracture

You certainly do not appear to have a significant capsular contracture from your photos. A grade 3 or 4 contracture will result in visible distortion of the breast. Also, you stated that your breast was not firm and it definitely would be with a capsular contracture.

John Whitt, MD
Louisville Plastic Surgeon

This doesn not look like capsular contracture.

Although bleeding is one of the most common causes of capsular contracture, your hematoma evacuation from the left breast (and placement of drain) seems to have yielded a nice result thus far on that side. However, you also are noting scar retraction with muscle contraction (activation distortion) and firm lumps under your right periareolar incision. This seems to indicate that you probably had bleeding in your right breast also, but not enough to require opening up the pocket and placing a... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Healing after breast augmentation

In addition to the other excellent comments i would suggest large dose vit e 2-3ooo units per day divided doses for several months and singulair or accolate for at least 90 days

Jed H. Horowitz, MD
Orange County Plastic Surgeon

Capsular Contracture? Will I Need Another Surgery?

I agree with Dr. Rand. This does NOT appear to be a capsular Contracture but an uncommon abnormal scar tethering the lower edge of the areola to the muscle. It should correct with time and massage. Alternatively, it may be CAREFULLY corrected by using a needle to divide the scar (subscision) and place either fat or a filler in the space to prevent the recreation of the scar.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Capsular contracture?

Based on your photos and story, it appears that scar tissue in the breast is causing the indention that you see. The scar form the incision down to the muscle is pulling and indenting the area below the nipple. Time and massage will often correct this, but it can take months to know whether a revision is needed. Capsular contracture refers to thickening of the normal tissue that surrounds the implant itself. It is less likely that capsular contracture is playing much... more

Michael S. Hopkins, MD
Albuquerque Plastic Surgeon

www.hopkinsplasticsurgery.com

Capsular contracture or not?

What you have looks more like tethering of the skin to the muscle causing a flexion deformity than capsular contracture. Presumably, the sutures are dissolvable and with time and massage this may well self correct. Only your surgeon knows for sure though.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Capsule contracture after surgery?

It doesn't look or sound like a capsule contracture. I agree with other response - more likely scar tissue attachment beneath the skin. Hopefully massage and PT will help. Check in with your surgeon.

Ronald Schuster, MD
Baltimore Plastic Surgeon

Breast Implant Encapsulation?

Thank you for the question. Your plastic surgeon will be able to most precisely answer your question. However, I read nothing in your description that fits with capsular contraction.It sounds more like an issue with localized scar tissue around the incision down to the pectoralis muscle. This would explain the indentation that occurs when you flex the pectoralis muscle. Hopefully this will resolve as scar tissue matures and softens; if not, revisionary... more