Tightness in Breast 2 Weeks Post Implant Revision

I had saline implants for 20 years and switched to silicon two weeks ago. At day 13 my left breast was more firm than the right breast. Is capsular contracture possible this early? Is there any possibility that it will self correct?

Doctor Answers (8)

Tightness in one breast 2 weeks after implant revision could be a problem.

+3

The most experienced surgeons are wise to listen to their patients when they describe differences in how one breast, for example, feels compared to the other, especially in the first days to weeks after an operation. The causes of this discrepancy, however, may range from "normal healing" to "bleeding on one side." Only an examination by your surgeon can determine which is which. Now, not at your regularly-scheduled appointment.

Even though every surgeon strives to do exactly the same operation on each breast to achieve the best symmetry, each side will bruise, swell, and have slightly different nerve sensations during the healing process. This is emphasized even more by the fact that we all use one hand more than the other (right-handed or left-handed), sleep more on one side than the other, and have natural asymmetries (left chest is rounder and narrower than the flatter and slightly wider right chest--because of the heart's position) that all contribute to very real and "normal" differences in the perceived healing of one side over the other. That's the good news: you probably have nothing at all going on and need only reassurance after a quick exam.

However, you could also have had a bit of bleeding on the "firm" side, and left untreated, can indeed develop capsular contracture. It's a very small operation to open the incision, remove the blood, cauterize or seal the oozing blood vessel, and resuture the incision. The "rind" of old blood that would have remained to contract and cause a hard, firm capsule has been removed, and the risk of capsular contracture has been decreased.

Or, some might choose to use ice bags, ace wraps, or tight surgical bras to try to stop any further bleeding, but what about the blood that's left in there? And isn't it a much bigger, bloodier, and painful re-operation to remove a capsular contracture later? (Yes, but sometimes denial and deferral seems preferable to prompt re-operation.)

Only your surgeon can help you decide just how severe the swelling and firmness differences are, and whether or not this warrants re-operation or reassurance. Either is possible, but not one of us online can help you determine this--only a prompt re-evaluation by your surgeon can accomplish this! Go see your surgeon now, and put your worries to rest! Good luck!


Minneapolis Plastic Surgeon
5.0 out of 5 stars 144 reviews

Capsular Contracture?

+1

Thank you for the question. Unfortunately it is not possible  to make an accurate diagnosis or to give you good advice  without examination. I would suggest continued follow with your plastic surgeon. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 793 reviews

Capsule contracture two weeks after breast implants not likely

+1

Differences in the breasts after implant replacement or revision augmentation are always a concern and a capsule contracture is difficult to imagine after just two weeks. It is possible that the capsule was not released adequately on the tighter side, or that  there is a problem such as bleeding. Better get in to be seen right away.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 31 reviews

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Early capsular contracture

+1

This is too early to tell at this point.  I would make sure that the surgeon is aware, but you need to give this more time.  This is not unusual for one side to be different than the other in the beginning.  Be patient.

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
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Time to see your surgeon for a follow up exam

+1

Dear Concerned,

Ask your surgeon about this difference.   It could be an early capsular contracture ( I doubt),   a seroma, a hematoma, or simply soft tissue swelling on only one side.  Perhaps your surgeon had to do more work on that side.   All the Best.       Dr Grant Stevens         

Grant Stevens, MD
Los Angeles Plastic Surgeon
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Tightness in Breast 2 Weeks Post Implant Revision

+1

This is of concern. Best to immediately see your operative surgeon to evaluate and determine the possible causes. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
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Tightness after breast surgery

+1

Being that you are only two weeks post-op from breast revision surgery, I would hold off worrying about a capsular contracture. It is a bit early for that to occur. Follwo your doctor's instructions regarding massage and contact him/her to be evaluated.

Steven Wallach, MD
Manhattan Plastic Surgeon
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Left breast more firm than right breast

+1

Asymmetry between right and left breasts during the early post-surgical period is not uncommon, especially asymmetry in texture.  The degree of this discrepancy is important.  If only mild, the difference is likely related to the amount of swelling (assuming you were symmetric before surgery and the same type and size of implant was used on both sides).  If the difference is greater, you may have bled on one side, or have fluid around the implant, a seroma.  Capsular contracture is not a factor 13 days post op.

Steve Laverson, MD
San Diego Plastic Surgeon
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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.