What is the solution for capsular contracture?

I've had breast augmentation 3 years ago cohesive gel 275 round smooth first time under the muscle then I came back after 6 months with cc on the left breast and then after 4 months again this happened and I had it done from the beginning both above the muscle and incision under my breasts. Was great until I had my second baby. Came back with the same cc on the left breast. I had it fixed 3 months ago and now the right one started causing problems and it's already grade 2. what to do next?

Doctor Answers 4

Recurrent capsular contracture

Capsular  contraction or is an unfortunate fact of life with breast augmentation surgery. Even with the best techniques it cannot be eliminated to 0%However with 30 years of experience in breast surgery, I have managed to drop this to about 1% reoperation in our practice.  The best options in my opinion for surgery are a sub muscular placement, use of the Keller funnel, avoidance of hematoma, and placement of drains to remove blood from the pocket as well as washing the pocket with Betadine antibiotic solution.  If there is a sign of a beginning contracture, however slight this can be prevented with cold laser treatment. In some patients treatment with singulair is also helpful.  I have seen many patients with mild capsule contracture of less than six months duration that have been helped with cold laser treatment and Singulair . If it is a long established contracture then re-operation is the only possibility. In that case there are multiple options including implant exchange  capsulectomy sub muscular placement,and or use of ADM  and aggressive post operative treatment with cold laser and singulair There are many different approaches to contracture, but this has been an approach that is successful for me  It is extremely rare to have to do the final solution to contracture which is removal of the implants forever 

Sacramento Plastic Surgeon
4.9 out of 5 stars 106 reviews

What is the solution for capsular contracture?

I am sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.  

In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix. Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin). I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps.  Best wishes for an outcome that you will be pleased with.

Capsule issues

Common treatment includes removing the capsule, placing a new implant under the muscle, and potentially adding an ADM.  You can also start over and remove the implants and wait 6 months and do the above. These are just some options.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Recurrent capsular contracture

Thanks for your inquiry and sorry for your struggles.  You seem to have a committed surgeon. It sounds like you will now have to address the right breast as well.  It is hard to predict if you will have further issues with encapsulation.

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