When exchanging implants due to capsular contracture, can I go bigger using the warranty? (photo)

I am 4 months post op and my right still looks like it did day 7. It is hard, and painful, and high. Right is significantly smaller, though the implant is actually 25cc larger. My natural aysymmetry was minimal. My ps says surgery to correct the cc is needed. My question is that if I have to go under again, and I do, how much larger can I go using the Natrelle warranty? It states a comperable size. What does that mean? I have 400/425, would like at least 500-600.

Doctor Answers 7

Implant Exchange and Correcting Capsular Contracture?

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4 months is a little early but it does sound like you have capsular contracture. The surgery to correct capsular contracture is not a trivial operation and there can be a significant risk of recurrence. The correction usually involves removing the existing implant along with complete removal of the capsule and then placement of a new implant. Then there are other considerations such as moving your implant to the submuscular position if your implant currently is in the subglandular location (Capsular contracture risk is higher in subglandular position), or switching to another incision if your original incision has a higher risk of capsular contracture (periareolar and transaxillary incisions). And remember, all surgery has some risks. If your left breast is fine do you want to subject that side to the risks of another operation? Your breast size looks good for your frame and your breasts are positioned relatively lateral on your chest wall. This means that you will predisposed to thinning of your tissues and lateral rippling as well as lateral displacement over time with a bigger implant. Moving to a significantly larger implant will potentially increase your risks for a number of other problems and you need to ask yourself if it is really worth it for the increase in size.

Implalnt exchange with contracture surgery

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Sorry about your contracture.  If you wait several more months after your surgery, I think it would be safe to consider volume change also.  It will depend on the pliability of the tissues as well as the degree of contracture on the right and the limiting nature of the capsule on the left also.  It is a complicated question that can only be answered with a physical exam at the time of the planning.  Good luck.  

David Marcus, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 34 reviews

When exchanging implants due to capsular contracture, can I go bigger using the warranty?

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Thank you for your question and picture. Sorry to hear you are having problems with your implants. As for the warranty for the Allergan implant line, your best bet would be for you or your plastic surgeon to contact the company to discuss the details of the warranty with the company and get the definition of what they define as "comparable." Since you have a good result on the left, I would assume that they would not offer to replace that implant, and only warranty the side that has the contracture. In that case, I would not advise placing a much larger implant on the right side as I think this will lead to a significant amount of asymmetry.

Hope this helps!

Capsular Contracture

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While I understand  you have your eye on the silver lining, looking at this as an opportunity to 'go bigger', but the reality is you have capsular contracture, and you certainly don't want it again after a revision surgery. That is why it is so important to do everything possible to prevent recurrence. Unfortunately, larger implants cause excessive tissue stretch, something that increases the risk of capsular contracture, and going 50% bigger into a tissue pocket that already looks stretched is not a good idea. Never mind the fact that if it did all  work out, your soft tissue envelope would be thinned substantially and you will likely have rippling. As for the surgery, be sure your surgeon is adept in performing a total en bloc capsulectomy through an inframammary incision, with or without an ADM to ensure no recurrence.  Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Capsular contracture after breast implant surgery

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It sounds like you might have some degree of capsular contracture after your BBA surgery. Removing the capsule and placing the new implant in a fresh tissue plane is generally the solution to this problem. One can increase implant size when doing revisionary breast implant surgery.

Size change under warranty

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Thank you for the question and it is one that does come up time to time and would require an opinion from the Allergan rep though I do not think it should be a problem to change for whatever sized implants

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Can I go bigger using the warranty?

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The best way to answer this question definitively would be to have your plastic surgeon call the Allergan rep and check with him or her.  The implants are not priced more for a larger size, so it wouldn't be any different to the manufacturer which size you chose, but given the fact that the warranty says that the size has to be similar, you may be out of luck going that much larger via the warranty.  However, keep in mind that a capsular contracture changes the shape of your breast and can make the size discrepancy seem larger than it is, especially when you state that your preoperative asymmetry was minimal.  Thus, you may not need to go that much larger to correct the asymmetry but rather just treat the capsular contracture.  Best of luck!

Jeffrey A. Sweat, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 51 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.