Capsular contracture. What would you advise?

Hi... Thank you for the question, Yes with time these could have more changes, on shape, hardness and even pain, generally with a capsulotomy or capsulectomy depending on the case and implants change these could be solved. 

If you have a mild case if may be treatable with a total or partial capsulectomy.  I doubt it will resolve without surgery and it may get worse but that is difficult to predict.

In my experience, if Accolate does not work in the first month to 6 weeks, it probably is not going to work. One of the mainstays of non surgical treatment for capsular contracture has been the application of therapeutic ultrasound. Specific protocols for breast have been described. Recently in our office, we have had good success with a therapy called z-wave. The z-wave machine produces linear sound waves that stretch the capsule back to being soft. If neither of those work or not be available, the surgical release may be necessary. Following up with your plastic surgeon is recommended. 

A significant capsular contracture is unlikely to get better without surgical intervention.  Capsulectomy to remove the capsule and insertion of a new implant wrapped in acellular dermal matrix is current recommended treatment.