Capsular contraction??

Question

Recently had 355cc motivas placed subglandular. I HATE THEM. They look horrible. they should have been placed sub muscular as I have no upper breast tissue and thin skin. my left breast looks like a football and hasnt fluffled. I have pain on the top of my breast when I touch it, i fear capsular contraction. I want them out and replaced.

Semih Yildiz, MD, FEPOBRAS · Answer

From the photos, the implants appear high and tight with some asymmetry, but photos cannot diagnose capsular contracture. If this is still early after surgery, swelling, skin stretch, implant settling, and subglandular pocket tightness can change over the first few months. Tenderness over the upper pole can also be part of healing, but worsening pain or firmness deserves an exam.
I would see your surgeon promptly, especially because you are unhappy and have pain. If the breast becomes progressively firm, more distorted, red, hot, swollen, or you develop fever, seek urgent evaluation. If the issue remains size, position, or implant plane after healing, revision to remove or exchange the implants and possibly change the pocket plane can be discussed once tissues are safer to operate on.

Leila Kasrai, MD, FRCSC · Answer

It would be a good idea to see your surgeon so you can express your concerns. A revision may be recommended to resolve your concerns.

Safa Sharabi, MD · Answer

Hi there,I agree that your results would likely look more natural with a sub muscular (dual plane) approach. I'm not sure (based on just the photos) if you have capsular contracture or if it's just an extremely thin overlying tissue envelope. You may even be able to get away with using the same implants when you do the exchange-- which would save you money. Happy to help however I can.Safa Sharabi

Muge Sevindik, MD · Answer

Hello, thank you for your questıon;You are very thin and have very loose skin and tissue. Therefore, both the subfascial plane and the Motiva implant were a wrong choice. Consequently, your implant should be removed, and a more stable result should be sought with a different plan and a different brand of implant.

Wayne I. Yamahata, MD · Answer

Your photos do not suggest the presence of capsular contracture at this time. The early diagnosis, i.e. firmness to the breast, requires a physical examination by your surgeon. With your concerns, a return visit to your surgeon would be recommended. He or she can rule out a capsular contracture and can discuss options to address your aesthetic concerns.

Daniel Barrett, MD · Answer

Dear fitxnurse,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ira H. Rex III, MD · Answer

Have you return to your plastic surgeon to review these things?  They would be in the best position to evaluate you for contracture and perhaps consider some type of revision.  With capsular contracture, sometimes we exchange the pocket, meaning they would be placed submuscular.  It seems you may be able to get a more aesthetic result with a little more attention to your situation.  Good luck with everything.

Arthur Dean Jabs, MD, PhD, FACS · Answer

You don't give much history as to your age, or breast history. Pre op photos would help as well.It appears a circumerential peri areolar lift was done on the L as well as the sub glandular augmentation.

Going sub glandular leaves the skin alone to support the weight of the implants and usually leads to a sagging breast within the first year. If you are unhappy with the appearance your options are

-Remove the implants
-Remove and replace in a sub muscular position (do as soon as possible and wear underwire support now)
-Remove, replace in a sub muscular position and to a mastopexy to even the nipple size on the L understaning that you are trading a larger L areola for a smaller one with a vertical scar.

All of these options should have been laid out by your surgeon before surgery with the plus and minus for each option.

Be sure to discuss your feelings and desires with your surgeon and wear support to decrease skin stretch.

Dr. Jabs

Javier Parada, MD · Answer

The optimal approach would be to perform an implant exchange with placement in a submuscular (or dual-plane) pocket, combined with excision and redraping of the excess skin envelope. This allows for improved breast shape, projection, and contour while addressing the underlying tissue laxity.
By adjusting the implant position and reshaping the surrounding soft tissue, a more stable and aesthetically balanced result can be achieved.

Donovan Rosas, MD · Answer

Capsular contracture is a progressive process which takes time to develop as additional scarring develops. It begins with alterations in softness followed by visual distortion and finally pain/discomfort.

Depending on how long ago your procedure was performed, it may or may not represent evidence of capsular contracture. Regardless, revision is typically delayed 6 months to allow for settling.

You do have options. However, much will depend on the final stabilized result.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Capsular contraction??

Answers (12)

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