Breast Implant Never Dropped? (photo)

Implants may take several months to settle. At 10 months, however, this process should be complete. The odds favor capsular contracture is the source of the problem.

                       Capsulectomy or pocket revision may be appropriate based upon exam findings.  The cost will probably be similar to the first or possibly less.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast augmentation revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Hello ladybug and thanks for you post. In the photos you have submitted it is difficult to see a capsule contracture. Both breasts appear soft and natural. A more objective evaluation by photos is best done with higher quality photos without your clothing in the way. Consider retaking breast photos is a manner similar to what you find on my website. Also, post your before surgery photos.  As far as what I can see.... Your results look excellent. Your cleavage and roundness is ideal. When there is contracture the breasts don't look this round. The asymmetry you have may be a reflection of your anatomy before surgery. Most people don't notice the asymmetry before surgery because they do not look at their breasts very much before surgery. Best wishes, Dr. Aldo.

Thanks for your pic and ? It does look like you have a slight asymmetry. Without seeing your preoperative pics it is hard to say if this is a difference in healing or an asymmetry that was present at the beginning. Implants can ride high also if the muscle has not been completely released. After 10 months the implant position is not going to change much. With regard to a capsular contracture, this would suggest that the scar tissue is abnormally firm. You will need to discuss these things with your plastic surgeon. It could be that all you need is a release of the capsule and muscle. Best of Luck!

If you can detect a difference in the firmness of your breasts, especially if it's the left one that's firmer, then most likely you have some degree of capsule contracture.  The classic findings in the case of capsule contracture are firmness of the contracted breast and upward displacement of the implant.  Capsule contracture is not a dangerous thing, and in the vast majority of cases it is mainly an aesthetic issue.  That is to say, that it is not a health or safety concern, rather nothing needs to be done about it unless you don't like the way the breasts look or feel.  Like most things, capsule contracture occurs along a spectrum, and some are worse than others.  Yours looks relatively mild from photos, but if you wanted to attempt to improve the symmetry of the breasts and the feel of them, then you may need to have the capsule removed and the implant put back in.  This is not a complicated procedure, but it is another surgery.  I generally don't like the idea of simply cutting the capsule, or capsulotomy, as a means of loosening it, because in my experience, the vast majority of those recurred.  We aren't sure why capsule contracure occurs, but we believe that in a large number of them there are bacteria involved.  Not that there is a frank infection, but if the capsule is left in there, then so are the bacteria, and one would expect a high likelihood of recurrence.  I do capsulotomy when the capsule is soft but the implant just needs to be lowered, but this is different than the case with firm contracture.  You should go back and see your surgeon and discuss your concerns with him and get his impression.

Thanks for your photos... when it comes to augmentation, my goal is to achieve an level upper pole so your tube top is level should you choose to wear one.  If your upper poles are level, then your breasts were asymmetric to start with, with one nipple being lower than the other (and this is very common and actually normal) and implants will not change this.  If your upper poles are not level, see your surgeon for suggestions on what can be done in attempts to improve this.  And finally, if you are not appreciating any changes, it is possible a revision may be needed.  You should know what your surgeons' revision policy is... and I strongly suggest everyone should know what their surgeon's revision policy is before signing up with them.

Have to say, overall nice result, but yes the left implant is a bit high.  Implants drop over the course of 2 to 3 months, but at 10 months feel that what you have is what you have.  Slight possibility that Accolate or Singulair ( off label use of leukotriene inhibitors used for asthma) could improve your situation, but think that either a left inferior capsulotomy or further potential release of pectoralis muscle could be performed to lower and reposition the implant without much difficulty.

In my practice, cost would be limited to hospital and anesthesia charges, which is far less that the cost for the original surgery.  This is probably your best option at this point.  Best of luck.

Generally, implants settle by 4 months so you are well beyond the timeframe such that your result is now stable.

Looking at your photos, it does seem that your implants may be at the same level on your chest wall and as such the asymmetry may lie in different nipple-areola positions. Only preoperative photos will help confirm this.

I'd see your plastic surgeon to find out if this is so. If it is instead capsular contracture, there are modalities to remedy it surgically which your plastic surgeon can address at the same time.

Best wishes.

Dr Kevin Ho

It would be interesting to see your pre-op photos and review the asymmetry between the two breasts. If it is a pocket issue it may just require a simple release along the inferior pole.  Best to be seen in person.

It appear that you left implant just stayed in a higher position as the capsule formed around it.  It does not appear to be a capsular contracture rather it is an implant malposition.  This is not too uncommon.   The correction requires a relatively minor procedure of releasing the bottom 10% of the capsule allowing the implant to drop in position.  I usually perform this procedure, when needed, under local anesthesia   It is my office practice to only charge for supplies when a touch up procedure is required.