Breast Implant Revision: Q&A
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Treatment for Capsular Contracture, What are My Options
I had breast augmentation in late January and in May was diagnosed with capsular contracture on my left side. It has not dropped nearly as much as my right side and is firmer and starting to have some pain as well. I am confused regarding whether to go back to my original surgeon because he does not believe in putting in a new implant or finding another surgeon that specializes in revisions or trying ultrasound treatments before opting for surgery again.
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9 Doctor Answers |
Asked by
alexa1208
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Treatment and prevention of capsular contracture
All breast implant surgery carries some chance of capsular contracture, in which the natural scar capsule contracts and the breast then feels hard. Contributing factors include hematoma (bleeding around the implant after surgery), and radiation treatment (for breast cancer). Probably the most common cause is an invisible layer on the implant called a biofilm, which is formed by bacteria from either the skin or the milk ducts within the breast tissue. For this reason it is typically...
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Capsular Contracture Options
In general, once a patient has capsular contracture, very little that you can do externally will make a difference. The external ultrasound is hit-or-miss, and does not make a difference in most patients. In order to address it properly, you need to go back in there and release/remove the scar capsule as gently as possible. This does not mean you have to change the implant. Contracture generally comes from trauma/bleeding in the pocket during or after surgery. ...
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Treatment of breast implant capsular contracture
Alexa, as you probably know, capsular contracture is the formation of abnormal scar tissue around the breast implant. Every breast implant has a capsule, but when the capsule is too tight around the implant, it usually requires surgical intervention. Its a little too early to jump into revision surgery (6 months post-op). I agree with some of my colleagues.
I recommend the following after 1 year
1) Capsulectomy
2) Implant exchange (Use same implant?)
3) Implant pocket...
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Treatment of capsular contracture depends on the severity of the problem
Dear Alexa,
Sorry to hear that your implant hasn't dropped, is firm and is causing pain. It sounds as though you have a Grade IV capsular contracture, which is the most severe type; patient's often complain of pain, firmness and a round, tight implant visually. Proven treatments for this include capulectomy, in which the implant is removed, placement of the implant behind the chest wall muscle, replacement of the implant with a new implant, and possible drain placement. For the...
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Options for capsular contracture are limited
The options for a capsular contracture are limited and there is no firm evidence that any medications will help, and even massage and ultrasound are of limited value. The treatment which gives the best success is open capsulotomy or capsulectomy (open and release, or remove the capsule) and for some replacement of the implant in a sub-muscular location. We have published success rates of 50% or slightly better. You can wait and give things a year or longer if you wish without harm.
Best...
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Capsular Contracture
Dear Alexa1208,
Capsular contracture should be treated in a way that is proven to yield complete resolution of the problem with the lowest risk of recurrance. Evidence based medicine indicates that closed capulotomy, massage, external ultrasound or leukotriene inhibitors like Singular and Accolate do not improve your condition.
Total capsulectomy and replacement with a new implant is the most appropriate and effective way to procede. Please see a breast surgery...
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You may start with primary plastic surgeon
The symptoms that you have described is consistent with capsular contracture. I would suggest going back to your plastic surgeon for revision.
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Capsular contracture
Dear alexa, it might be a good idea to get a second opinion. revisional surgery after 5 months is somewhat early but it depends how severe your capsular contracture is, if you have pain etc. good luck
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Treatment for early capsular contracture
Dear Alexa1208,
Capsular contracture vexes breast augmentation patients as well as plastic surgeons. At this point I believe here are your options besides doing nothing:
1) Trial of Singular( a medication) as an "off label" use to attempt to soften your breast. Some surgeons favor other medications attempting a similar response. By this point in your recovery, I would not expect this to be a fruitful option but could be a "first...
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