How Early Can Capsular Contraction Start and What Are the Symptoms?

I just had a breast augmentation with a crescent lift 10 days ago. My left breast has already settled in nicely, but my right breast still sits high on my chest, my ps has told me this is quite normal, my concern is the inside of my right breast is nice and full but the lower outside looks flat and deflated still, could this be an early sign of capsular contraction? How early can capsular contraction start?

Doctor Answers 18

Capsular Contracture Timeline and Symptoms

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Your plastic surgeon is probably right.
Although capsular contractures following breast augmentation  can occur just about anytime, most women start having symptoms around three months after their breast implant surgery. This is because it takes some time for a capsule to form and then to scar down (contracture). Therefore it is probably too early at 10 days to be concerned about this problem. Your signs and symptoms are most likely from muscle spasm although other factors could also cause this. Your plastic surgeon should be able to sort this our in short order.

Signs and symptoms are going from a soft breast in good position to a hard one that looks hard and round like a ball usually after 3 months that tends to ride up your chest and can eventually be painful.(i.e. hard, deformed, displaced)


Unlikely contracture this early

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Capsular Contracture can start early when there is infection or another co-existing problem. It is rare however. It is more likely this early that one implant has simply not "dropped" yet. This can happen when the muscular tone on one side is greater than that on the other. Follow the progress along with your surgeon. It might take a few weeks to a month to sort out.

John P. Di Saia, MD
Orange Plastic Surgeon

This is not capsular contracture.

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Hi. Unfortunately, I think you have a fairly common complication (different pockets on each side), and your right breast will probably need to be revised in a few months. Complications happen. It does not mean your surgeon did any thing wrong.

Implants are not supposed to "drop". Your breasts should look good right after surgery.

The way I try to avoid this particular complication is to place the patient in the sitting position DURING surgery (you are still asleep, of course). This way, the surgeon can make sure the breasts look great and are symmetrical before the end of the operation. If shape and symmetry are not as good as they can be, I keep working and repeat the process. This takes the guess work out.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

I have seen contracture start ~2 weeks, perhaps sooner

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This is quite rare, however. I would defer to the surgeon, as he has benefit of exam, and he knows the technique. If, for example, the implants are under the muscle, they do tend to "hang" for 3 to 4 weeks before descending. Also, each breast is unique, and settles at its own rate. Don't let that make you nuts.

The contracture is due to excessive scar tissue squeezing the implant, and this can cause the implant to become hard, deformed, displaced. It can also cause pain. I would hold tight, don't get too anxious, and re-visit the question on next visit.

Capsular Contracture

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Fortunately it is very unlikely that you've begun developing capsular contracture 10 days after breast augmentation surgery.  It usually takes at least a couple of months for a well developed capsule to develop first.  It is also very common for one implant to settle sooner than the other side.  This is not usually a concern. Hopefully your Plastic Surgeon is readily available to answer your questions and address your concerns through the healing process as well. 

Capsular contracture

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Capsular contracture usually arises months to years after breast augmentation surgery, when it occurs. What you are describing sounds like the right breast has not yet settled or dropped into its final position, rather than capsular contracture. Settling of implants usually occurs by about 6 months post-operatively and can be aided by massage or elastic band techniques. Discuss these with your surgeon.

Lara Devgan, MD, MPH
New York Plastic Surgeon

Capsular Contracture May Occur At Any Time Following Breast Augmentation

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Capsular contracture can occur at anytime following breast augmentation surgery. Most cases become apparent three to four months following surgery. The incidence of capsular contracture continues to slowly increase as long as patients have breast implants.
It’s unlikely that you have a capsular contracture. In the immediate post-operative period, breast firmness is usually the result of swelling and not capsular contracture. In most of these cases, the firmness resolves with the passage of time and massage.
If you’re breast firmness fails to respond over the course of time to conservative maneuvers, you may have a capsular contracture. This can result in breast firmness, breast distortion, and pain. Consultation with your plastic surgeon should clarify this issue.

Uneven Breast Implants

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Although capsular contracture may begin soon after breast augmentation, it is highly unlikely at this point.

I would ventrue that your breasts may have been slightly uneven to begin with your right being slightly lower/larger. Some implants take a while to descent into the breast and this sounds as if this is what you are describing. Occasionally, we have patients perform preferential breast implants on the higher side to "encourage" the implant to settle faster.

Given the early time after surgery, it is likely your breast implant will settle over time and this may take 6-9 months to fully assess. There may be many reasons why one implant sits higher than the other. In some instances this may require surgery at a later date but that decision is best deferred for now. I have seen many implants even out over time.

Discuss your concerns with your surgeon and try to be patient.

Most likely not a contracture

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It is unlikely for a contracture to occur this early unless you had significant bleeding or an infection. It sounds as if the pocket is not large enough on the one side or just hasn't dropped yet. As I wrote earlier, most implants take 4-6 weeks to settle into place, so don't rush or worry.

Follow the doctor's order for massage and exercise.

Good Luck.

Not this early!

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Hi puppet4565, you are in the immediate post surgery healing phase! You are only 10 days post op. It can take months for you to see your final result. You are swollen for at least a week or two after your surgery, even after your swelling goes away, depending on the size and position of the breast implant pockets created, as well as the size of the breast implant used, the muscle and skin can take months to stretch and accommodate the new implant. (And as shown by your example, it rarely happens evenly for both sides in a simultaneous fashion.) This process gives the appearance of the implant "dropping" or " the drop and fluff", as some surgeons say.

That being said, although capsular contractures following breast augmentation can occur just about any time, most women start having symptoms around three months after their breast implant surgery. This is because it takes some time for a capsule to form and then to start to contract. Just make sure you show up for all of your scheduled follow up appointments and speak to your surgeon about any and all concerns.

Capsular contracture occurs when the scar tissue capsule your body naturally forms around your implants thickens, tightening around the implant. This may occur on one or both sides and may cause a shape change, discomfort, and may cause the breast to feel more firm. You may notice that one or both of your breasts are not as soft as they once were or may actually begin to harden, your breasts may begin to look or feel different, or you may experience some discomfort from the tightening of the capsule. 

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.