Advice for Approaching Repeated Capsular Contracture?

I'm looking for opinions ASAP since I meet with my plastic surgeon and her partner on Tuesday. I had submuscular, round, smooth, silicone breast implants in June 2007. A year later, I had capsulotomy for left breast. According to the chart, there was no capsule. Maybe the pocket was made too small? The chart reads "slight thickening at top but no capsule."

The capsule was released laterally and inferolaterally. Shouldn't it have only been released on the top? Less than a year later, it bottomed out, and another revision was done on May 1st 2009. One month post op, left breast is still bottomed out. Any advice on how to approach this problem?

Doctor Answers 3

You look pretty good to me

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I do not see bottoming out in your images. It is difficult for me to understand why you had additional surgery if you looked like this before that surgery. Were your breasts firm or painful?

Orange Plastic Surgeon

Your pictures look quite good!

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If the pictures are accurate, I am not sure why you need a revision breast augmentation. I don't really see significant bottoming out. Before surgery, the fold under your left breast was lower than the right fold.

If in fact you do have bottoming out, this is easily and permanently corrected. We use internal permanent sutures and Alloderm.

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

Repeat breast implant surgery

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Bottoming out means that the distance from the nipple to the infra-mammary fold increases from after surgery to the present time. When a patient has bottoming out, it can be corrected by sewing the bottom of the pocket smaller, creating a new pocket, or inserting a thin sheet of special material to reinforce the lower part of the pocket.

Capsular contracture means hardening of the capsule which usually causes the implant to move higher and feel harder. It can be corrected by removing the hard capsule and replacing the implant. In some patients a medicine called Accolate can improve capsular contracture without surgery.

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.