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325cc Silicone Mod. Plus Profile for Post-baby Breasts - Right Implant Moving Up on Chest

I had a great experience with my augmentation. My...

I had a great experience with my augmentation. My recovery was quick and I had little pain. I had the surgery to fill out the loose skin and fill in the empty breasts having two children and gaining then losing weight left me with. I chose to get 325cc moderate plus profle silicone implants. I went with silicone to minimize rippling since I had very little existing breast tissue and a thin frame. I am 5'6" and weigh about 118 pounds. I barely filled out a 32 A prior to my surgery and am very pleased with my results so far.

About a week ago, I noticed that the right breast has started moving up my chest and when I lift my arm the incision goes below my crease. I called my PS, he said to come in so he could take a look. He could see what I was talking about but said the implant had good movement within the pocket and did not feel firm. He was a little concerned that the implant does not seem to rest all the way at the bottom of the breast, and said this is often seen with capsular contracture. The implant can be pressed down into the pocket, it just does not stay down. This is a new issue since my 6wk follow-up. He said at this point to keep massaging and see him in a month and possibly then try taking Singulair if I am not seeing improvement. I have been keeping a picture diary of my progress each week and you can clearly see that the right breast has moved up. I can see a change in the position of this breast and I can feel a difference. The left breast is now softer than the right and if I press on the right implant, it is soft but I also feel resistance that is not there on the left. The implant can move up, down left and right, so I can see why my PS is hesitant to label this as capsular contracture. I am just concerned that there may be more I can do.

Updated on Jul 18, 2009

I need to be sure that I am doing everything...

I need to be sure that I am doing everything possible to try to prevent a complication and am unsure if I should seek a second opinion or be doing anything else.
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Comments (9)

Lynn, I have the exact same problem with my right side. It was slightly higher before surgery, but not too noticable. After surgery, I noticed that my right side was not fully dropping, and went to my doctor every 6 weeks for six months with my concerns. He finally diagnosed me with capsular contracture. No amount of massage/compression or vitamin E has helped, and I never did use Accolate or Singulair because I was already a Grade III or IV by the time it was diagnosed. I am now going in for a revision. I hope since yours is being caught earlier that you will have better luck.
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I am hopeful that something will be done sooner rather than later. I emailed my PS pictures on Friday and he messaged me back to come back in to reevaluate things and discuss any possible assymetry. I'm not sure why there is hesitation to diagnose a patient with capsular contracture, because I hear this from many sources. I wonder if it has something to do with the FDA and having to report capsular contracture cases to them? Not really sure and I doubt a doctor would say if that was why but if so the FDA should give breast implants a break...LOL You would never hear them say that pacemakers or joint replacements are unsafe because they might form scar tissue. I'm sorry yours got so bad before anything was done. I sure hope that my PS wants to take action now. Good luck with your revision.
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The facts are that some capsular contractures can be treated non operatively - and I would do everything that I can to be one of those patients. Patients with secondary operations for capsular contractures have a higher incidence of repeat capsular contractures than primary surgical patients. What that means is that you are not guarenteed to be better by having surgery. It should be the last result. Delaying it does not reduce your likelihood of a better result. Good Luck
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Thanks, that makes sense! I see my PS again tomorrow for a follow-up so hopefully it goes well.
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It is sounding more like a capsular contracture and it would be best to discuss this with your surgeon and how you might deal with it.
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Thanks, I did discuss this with my doctor and he said that mild capsular contracture isn't an emergent situation so there is no rush. He instructed me to massage several times a day and do compression exercises. He said after a month if I do not see improvement that taking Singulair would be an option (an option that I am not interested in) All the research I have done on Capsular Contracture suggests that early tx and capsulectomy yields the best results and that things like massage, medications, etc are not really reliable ways to reverse it. I am hoping to get some feedback as to what other PS do with patients who have mild cases of CC, so that I can gauge if I have unreasonable expectations, as I would prefer to have the capsule removed rather than attempt to manage it.
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I wish that I had pre-op pictures, my PS has some in his office but I do not have any. There was some minor asymmetry but according to him it was nothing that would be noticeable post-op. I am most concerned with the fact that the right breast was lower and symmetrical with the left and now seems to be inching back up my chest and the left breats' nipple seems to be increasingly pointed laterally. I have a picture from 6-8-09 in which both breasts are symmetrical and the nipples are pointing straight ahead. My PS initially said massage was not necessary,but at 6 weeks when these changes started occuring had me begin them in addition to compression.
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It would be useful to see your preoperative photographs. I would bet that your Right Breast was always higher( the inframmary fold) than the left. Are they smooth wall implants and do you exercise them? You might ask your surgeon for a "breast band". It is a device that you wear over your breasts that slowly push the implants down - more effect on the higher implant.
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Dr. Greco, MY PS did mention before my surgery that I had slight assymetry but that it would be even less noticeable post-ba due to the increased volume. While I was barely a 32 A cup for the past two years since having my son, about 5 years ago I was taking corticosteriods for approx a year, I gained a bunch of weight and was wearing a 34C. My husband and I both have said that there weren't any noticeable differences in my breasts then. Even looking at old pictures of me in bathing suits and clothes you don't see any differences in the height of the breast mounds either, nor did I ever have issues with bras not fitting properly. Right now, if I were to put an underwire non-padded bra on, the right breast has about a 1 inch gap above the underwire whereas the left breast sits snuggly. Are these poor ways for me to gauge how my breasts have changed since the surgery? Can a crease actually drop lower on its own after a BA? I don't know what happens when I go to my PS, even if I go with a list of questions or things to say, he ends up saying something that throws me off and I end up leaving feeling ok but getting home and feel sad again. I know that I can't expect medical advice on the internet, nor would I want it really. I am just hoping for some general information as to what options are out there so I can at least bring them up to my PS and see if they are options that might work for me. Thanks so much for your time!
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