Good Idea Not to Replace Breast Implants After Capsular Contracture?

I have a stage 4 capsular contracture in my right breast. I had my surgery 6 years ago. I am considering not getting the breast implants replaced and have an augmentation done. Do you think not replacing the implants are a good idea? I am told by 3 different doctors that I have enough breast tissue to create a full breast.

Doctor Answers 7

Neopectoral pocket for recurrent caspular contracture.

I  would consider implant removal and replacement in a neopectoral pocket to reduce the potential for a recurrent capsular contracture.

Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Breast Lifing, Augmentation, Recovery, capsular contracture

Dear MiaHope, you have several options on your situation.

1) remove the implants only- wait and do a breast lift later

2) remove the implants and do an immediate breast lift

3) remove the implants, have and open capsulotomy and replace the implants

4) remove, open capsulotomy, replace the implants and immediate breast lift

If you have a breast lift- the breasts will appear smaller- even if no tissue is removed.

There is a medication called Singulair which is used for childhood asthma- as an off label prescription it can be helpful with Capsular contracture.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 115 reviews

Breast implant replacement after capsular contracture correction

Dear MIA,

"...I have a stage 4 capsular contracture in my right breast. I had my surgery 6 years ago. I am considering not getting the breast implants replaced and have an augmentation done. Do you think not replacing the implants are a good idea?"

Your question can be interpreted in 2 ways:
1. INSTEAD of - augmentation you meant to say capsular correction OR breast lift.

2. Or you MAY be asking it the OLD implants can be left in AFTER removal of the scar tissue.

For the benefit of others, a BAKER Class IV contracture is a breast where the scar around the implant is VISIBLE, PALPABLE and the breast is PAINFUL. The breast is deformed and tender.

The only way to relieve the condition is to remove most or all of the scar along with the implant (pericapsular dissection with partial or complete capsulectomy). If the implants are NOT replaced, the resulting breast will be smaller and droopier. The shape may look more attractive if a breast lift (mastopexy) is done.

Can older saline implants be reused and replaced? Yes but it is probably a better idea to go with a fresh, slightly larger pair of implants if you choose to go this way.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Replacement of breast implants after type 4 capsular contracture


You have some options. It sounds like you have adequate breast tissue and that removal of the implants will not make you flat. You also mentioned that you might consider a breast "augmentation" but I think you might mean a "reduction" or a breast lift.

If you have had such a serious reaction to a breast implant it may have resulted from a sub-clinical infection, seroma or hematoma at the time of the original surgery, or just an overly reactive scar formation after your surgery. It is possible to perform a capsulectomy and replace the implants in a different plane such as sub-muscular or sub-fascial.

My best advice is to go to a qualified board certified plastic surgeon and discuss the various options that you have before you undergo additional surgery.

Hope this helps.

Joel B. Singer, MD
New York Plastic Surgeon
3.4 out of 5 stars 34 reviews

Capsular contracture

 To undergo another surgery after developing a capsular contracture is possible.  The old capsule should be removed and certainly if you want new implants they can be put in.  

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Explore all options--realize breast lift may be necessary.

The treatment of capsular contractures can be difficult and is often associated with significant frustration.It’s important to realize that a large variety of options are available to treat this condition. The exact choice will depend upon your anatomic findings and aesthetic goals. For this reason, it’s important that you carefully consider all your options.
If you no longer want breast implants and can accept a smaller breast size, it is not unreasonable to remove the implants and perform a capsulectomy. It’s important to understand that additional procedures may be necessary for aesthetic reasons. For this reason, breast lift surgery may be necessary to treat breast sag and create an aesthetically attractive breast.
In contrast, if you still want larger breasts, a multitude of options are still available.These include placing the implants in the original breast pocket following capsulectomy.It’s also possible to create a new breast pocket in a new location.It’s important to understand that the potential for recurrent capsular contracture is high whenever implants are replaced following capsulectomy.For this reason it’s important to consult a board certified plastic surgeon with experience in this area.This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Capsular contracture treatment

Capsular contracture can be difficult to treat. If you have enough breast tissue to be happy with your size after removal of your implants, then not replacing the implants is good idea as it will remove the possibility of having capsular contracture again. You will likely have a breast lift to improve your breast shape after implant removal. There is no harm in leaving the implant out and if you are unhappy with your breast size to revisit having an implant placed back in sometime in the future - 6mo or more once you have healed from your surgery. Discuss your options with your surgeon carefully and be sure to understand the trade-offs with the choice you make.

Bahram Ghaderi, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 21 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.