I've Had 2 Breast Augs & May Need a 3rd Due to Encapsulation. Should I Have a 3rd? Should I Change the Type/size?

Hello,

I am sorry you are having these recurring problems with your breast augmentation.  Although not completely understood, capsular contracture is a process associated with inflammation, usually caused by bacterial contamination of the implant.  There is also a genetic predisposition as well that might make you more prone to it.  (note: if it were all due to genetics, then both breast implants would be contracted.) 

There are some myths that are not substantiated by science or my experience with the complication, one specifically is that heavy exercise will cause the problem to happen or recur. Many of my patients are body builders, fitness models, gym rats, and yogis doing strong inversions on their hands day in and day out, but none of them have a higher rates of capsular contracture.  Most of my colleagues will concur with that as well.  It is true that excessively large implants put you at higher risk for initial capsular contracture, but not recurrent cc.

The optimal treatment of capsular contracture is total capsulectomy (complete removal of all scar tissue around the implant), placement of a drain, and replacement of a new implant via a 'no touch' technique like the Keller Funnel.  There is a growing body of evidence that products like Strattice or Alloderm (acellular dermal matrix) might decrease recurrence as well. In my practice, my patients take Singulair for one to three months post capsulectomy.  I do not regularly use Strattice, except upon request by the patient.

Unlike primary breast augmentation, total capsulectomy is a challenging, sometimes exceedingly difficult surgery to perform optimally.  Frequently, excessive bleeding due to inadvertent injury to the surrounding tissue puts the patient at higher risk for cc again. Therefore, some surgeons choose to do limited capsulectomies.  Unfortunately, these surgeries lead to higher risk of cc!

Discuss with your doctor what he did for you and explore your options for any future intervention. This conversation would include type of surgery performed, the use of drains, the use of drugs like Singulair, and the use of ADMs like Strattice.

Best of luck!

Thank you for your question. There's a saying in plastic surgery that one must have a plan A and a plan B, but B should not be like A. So, doing plan A for the third time, what will prevent it from failing and being a success? That's what I thought too. Obviously without photos and the benefit of an in person examination, I can give you only general guidelines. I would suggest using Strattice, a tissue matrix, and also a site change (a new pocket) and gel implants. Talk to your surgeon or seek a second opinion from a board certified plastic surgeon. Good luck.

Not sure where your pocket is made but releasing the muscle and using stratus is a good option to try to control capsular contracture.  Popping the encapsulation is not a good choice and is painful.