Do I have capsular contracture? If so, what non-surgical options are available for me? (Photo)

I got surgery 9 months ago from a b to a d 335cc. They are still very hard. Do you think I have capsular construction? If so what can be done thats non surgical as it's not an option for me to see my surgeon again as he is overseas. Is there anything I can do? If so approx what cost am I looking at. Thanks

Doctor Answers 11

Nonsurgical treatment of capsular contracture.

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Capsular contracture can sometimes be treated by a closed capsulotomy. This maneuver is falling out of favor but it does work and avoids the operating room. Drug treatment has been ineffectual in my estimation.

Capsular contracture treatment options

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Capsular contracture treatment options
There are limited options.  One other choice is the Aspen ultrasound device.. I have no personal experience but the reported results look good.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Non-surgical maneuvers for contractures

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are really desperate measures taken to avoid surgery... but most people end up having surgery.  I'm surprised that so many go abroad, presumably to Thailand.  But if you think you are having a contracture, its nice to confirm that indeed you do.  Breasts can be firm depending on the implant used and the pocket dissected but is your shape distorting?  Accolate/Singulair have been observed to help but there is no scientific proof at this time.  A company named Aspen makes an ultrasound that is supposed to help.  If you can find someone down under who has this and who is willing to provide some kind of warranty to you so you either get a result or some money back, then you could consider it.  If you develop distortion, you really need surgery. 

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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Capsular contracture

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Sometimes, Singulair can work but if your capsular contracture is severe you will most likely need surgical correction.

Non-surgical options for capsular contracture

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Hi.  If you have an early contracture, there are a few non-surgical options that sometimes work.
1.  Use of Singulair
2.  Use of Papaverine
3.  Use of "B.I. Secret", a proprietary blend of herbal extracts - has helped a few of my patients
4.  Therapeutic ultrasound

But mostly, for established cases, with very firm capsules, surgery is the answer.  Perhaps you should speak with a plastic surgeon in your neighborhood.

Do I havre capsular contracture?

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Capsular contracture is due to thickening of scar tissue around the implant and will cause the implant to feel hard and immobile

The problem is that the solution is surgical excision of the capsule.  There are really no other options once the capsular contracture is established.

Jeremy Hunt

There are no proven safe nonsurgical options for capsular contraction.

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The proper treatment of capsular contraction is removal of the implant capsule exchange of implants and the use of acellular dermal matrix wrapped around the implant.  An older technique called a closed capsulotomy is not routinely performed today because of the risk of implant rupture and avoiding of your breast implant warranty. Medications given after the capsule has formed have not been shown to make a significant improvement.

Capsular contracture after Breast Augmentation / Contractura Capsular luego de una Aumento Mamario

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Capsular contracture is a complication that can be present at any moment after a month of a breast augmentation surgery. You pictures are so small that we can not see anything or details. Do you know what brand and kind of breast implants do you have and if they were placed under or over the muscle? Were they hard since the beguining or they became hard a few days ago? Are both sides feeling the same texture when you touch them? You can schedule an appointment with an ASAPS member plastic surgeon in your area to see his opinion.

Spanish Translation: 

La contracture capsular es una complicacion de la cirugia de aumento mamario con implantes de silicona que puede presentarse en cualquier momento luego de haber transcurrido un mes del procedimiento. Tus fotos son muy pequenas y no podemos distinguir detalle alguno o deformidad. Sabes el tipo de implante y marca que te colocaron y si fue debajo del musculo o delante del mismo? Han estado con consistencia dura desde el principio o percibiste esto recientemente? Se sienten iguales ambos lados al toque? Te recomiendo agendar una cita con un cirujano plastico en tu localidad miembro de la ASAPS.

Luis Lopez Tallaj, MD
Dominican Republic Plastic Surgeon

Do i have capsular contracture: probably

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It is hard to appreciate the consistency of your breast from the images you posted which are very small, and usually to show contracture in photos I ask patients to squeeze their breasts between their fingers. However from the description you have written it is quite likely.

Using medications, such as Singulair  and other "leukotriene inhibitors" has been almost universally disappointing. While it is possible to reduce the degree of contracture slightly, the results are never sufficient to give a patient a satisfyingly soft outcome.

Massage, which isn;t actually massage, but really  forced "implant displacement", which aims to stretch the capsule and keep the space less effective at preventing contracture than was once thought, and is pretty much useless for established contracture.

The most effective treatment is surgery, and what surgery needs to be done depends on whether your implants are above or below the muscle. Sub-glandular implants ( above the muscle) can often be removed and replaced under the muscle with removal of the entire capsule ( capsulectomy)and a soft result is usually the outcome, although the contracture rate is still higher than it is with primary  ( first time out) augmentation under the muscle.

Capsulotomy, or expanding the space only, is rarely a long term effective solution with implants above the muscle but may be effective with them below. If they are below already, the risk of recurrent contracture after capsulotomy is significant.  I would not suggest immediate use of acellular dermal matrix as it is expensive and though some reports are encouraging it is unclear whether the enthusiasm is warranted as yet. 

Current thinking suggests contracture may be related to low level bacterial growth from organisms living in and around the breast tissue, and that when contracture is a problem replacing the existing implants may improve the chance of success

You do also have the option of removing your implants, although I doubt at this point you want to consider that. 

You should see a qualified plastic surgeon. Australia has a very good plastic surgery community.

Benjamin Gelfant, MD
Vancouver Plastic Surgeon

Capsule contracture options

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Some medication such as Singulair have been discussed as helping with capsule contracture.  The best treatment is implant replacement with capsule removal and possible use of dermal matrix.  Until you see your plastic surgeon you may want to touch base with your plastic surgeon about possibly starting Singulair and a massage protocol.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 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.