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1 Year Post Breast Implants: Worried I Have Capsular Contracture

A year ago next tuesday 5/10/2010,I had breast implant surgery, 36DD, saline implants, high profile, under the muscle(My left breast was always a half cup size smaller than my right) My fourth visit after surgery,I mentioned to my PS my left breast implant felt lower than my right, he imformed me to keep massaging and everything should fall into place.

Last month or so I noticed my left breast was tender under neath, feels slightly tight and looks as if its sitting higher than my right. Worried!!

Doctor Answers (12)

Possible capsular contracture 1 year post-op?

+3

At one year post-op, your description is accurate for capsular contracture. Since bleeding and bacteria are the two most common causes of (late) capsular contracture, do you remember any moderate trauma to your left breast at about the time of the tightness, tenderness, and switch from sitting lower to higher than the opposite breast? If so, you might have had some bleeding, which now has developed into the tight, firm, sore capsular contracture. The other cause would be bacteria--can you specifically recall an incident where you may have been ill enough to have bacteria in your blood stream at the same time as a minor bump or bruise to the breast that could allow the bacteremia to enter the space around your implant and stimulate the capsular contracture? The most common scenario where this can occur is with dental work, including cleaning. I have seen several cases of dental work-induced capsular contracture (late, unilateral, 1-3 weeks after dental work). Though I am in a minority of plastic surgeons who do this, we believe that antibiotic prophylaxis prior to dental work is appropriate to minimize the risk of developing capsular contracture from dental work.

Regardless of the cause, it appears as if you do really have capsular contracture, and may well require surgical intervention. If you capsule is early and relatively mild, a course of Singulair or Accolate and Vitamin E may reduce the severity of the capsule enough to avoid surgery, but I have seen this work in only a few cases. Still, if your capsule is mild and early, this may be worth a try!

Otherwise, you will require surgical capsulotomy, capsulectomy, and possibly new implant(s). Certainly the size of your implants leave little room for contracture, but unless you really feel too large, I have to assume that until this left-sided contracture developed, you were happy with your size. Smaller implants in the present pockets may be an "easy" fix, but may not be the best surgical choice. Rely on your surgeon's advice, as you will be returning to him or her if the capsular contracture worsens or recurs.

Web reference: http://www.mpsmn.com/html/breast-augmentation.html

Minneapolis Plastic Surgeon
5.0 out of 5 stars 91 reviews

Capsular contracture.

+2

Given the history you've provided and the photos, I would agree that you probably have a capsular contracture of the left breast. That being said, your implants are high in both breasts as seen on the profile picture. The silhouette of the right breast shows a tight lower pole of that breast as well. I recommend a follow up examination with your plastic surgeon to evaluate your options. This may include a revision of both breasts to improve the implant placement as well as correct any capsular contracture.

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

Boca Raton Plastic Surgeon
5.0 out of 5 stars 8 reviews

1 breast implant higher and tighter one year after breast augmentation may be capsular contraction

+1

Thank you for your question and photographs. The symptoms that you describe, with 1 breast implant feeling firmer and looking higher could suggest a capsular contraction. Be sure to see your plastic surgeon

Web reference: http://drseckel.com/surgical-procedures/result-oriented-breast-augmentation-breast-enlargement/

Boston Plastic Surgeon
5.0 out of 5 stars 24 reviews

Signs of Capsular Contracture

+1

Thank you for your question.  Capsular Contracture is one of the main risks of breast augmentation.   Classic signs are:
1.  hardness/tightness of the implant
2.  change in implant position (typically migrates towards the collarbone)
3.  increased pain and stiffness on the associated side.
Based on your description, you should see a board certified plastic surgeon for evaluation of capsular contracture.    If present, I would recommend a capsulectomy (removal of scar tissue) and implant exchange.  
Factors to consider:
1.  If your implants are above your muscle, you may want to consider switching to underneath the muscle, which lessens the risk of capsular contracture.
2.  If your implants are above the muscle and you desire to keep them there, you may benefit from the use of a textured implant.
Dr. Gill

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

Houston Plastic Surgeon
5.0 out of 5 stars 32 reviews

High Riding Implant, Capsular Contracture?

+1

The patient illustrated in this picture is presenting high riding implant on the left side. There are multiple reasons for that; these implants can be too big for her to start with and also it may be a high riding implant or it may be a capsular contracture or both. Whatever the problem may be it can not be fixed by just massaging the implants, this patient will require some kind of revision surgery. During the revision, it is highly recommended that these implants be changed for a smaller size.

El Paso Plastic Surgeon
4.5 out of 5 stars 15 reviews

Another vote for revision of augmentation with smaller implants

+1

its hard to tell without a hands-on exam exactly what factor(s) are causing the appearance here, but clearly a revisional procedure will likely need to be considered.... and i would strongly recommend that this time smaller (and perhaps lower profile) implants be part of the "fix".

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

Schenectady Plastic Surgeon
4.5 out of 5 stars 11 reviews

Breast implant capsular contracture

+1

It is possible that you have a capsular contracture, but merely having the implant sitting at a different height would not indicate that. Your surgeon would have to examine the implant to see if the capsule has in fact hardened, causing the malposition.

Sugar Land Plastic Surgeon
5.0 out of 5 stars 11 reviews

Capsular contracture

+1

You  may very well have a capsular contracture of your breasts, but a formal exam would be essential to evaluate this correctly.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

Your implants are too big for your breast

+1
Your implants are too big and youmay have capsular contracture. The other possibility Is that your muscle was not released and did not let the implant to expand the lower pole of the breast. You need examination and revision with smaller implants.
New Orleans Plastic Surgeon
5.0 out of 5 stars 46 reviews

Early capsular contracture after breast augmentation

+1

Unfortunately capsular contracture is a possibility at this stage, particularly if you notice any tightness accompanied by change in the position of the implant (implant riding high) or change in the surface of the breast (for example any rippling effect). I would suggest visiting your surgeon who can easily allay your anxiety or advise appropriately.

Birmingham Plastic Surgeon
5.0 out of 5 stars 5 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.