6 months post breast augmentation, the left breast is harder and larger, could it be capsular contracture?

I had breast augmentation 6 months and 8 days ago. The left side of my breast is larger than the other. The right one looks rounder and as if the breast formed around the implant. While working out, I felt the strain on my left breast. I noticed a floppy pocket of skin. Can my breast swell from working out and will it heal eventually and settle like the right one? It feels soft and not hard at all. Could it be capsular contracture?
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Doctor Answers 7

Difficult to say, but I think you need a breast lift to get the best results

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It is hard to answer the questions about contracture without an exam, but the thing that really jumps out at me from your photo is that a breast lift would really be the most effective way to rejuvenate the appearance of your breasts.

The downside of this is of course additional incisions, but in my mind, this would go the furthest to give you the best result. If your surgeon detected a capsular contracture, he could correct this as well at the time of the procedure.

My recommendation would be to see your surgeon and have an honest discussion about all of your options, and the advantages and disadvantages of each.

Good luck,

Dr. S

Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Signs of Capsular Contracture

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Thank you for your question.  Capsular Contracture is one of the main risks of breast augmentation.   Classic signs are:
1.  hardness/tightness of the implant
2.  change in implant position (typically migrates towards the collarbone)
3.  increased pain and stiffness on the associated side.
Based on your description, you should see a board certified plastic surgeon for evaluation of capsular contracture.    If present, I would recommend a capsulectomy (removal of scar tissue) and implant exchange.  
Factors to consider:
1.  If your implants are above your muscle, you may want to consider switching to underneath the muscle, which lessens the risk of capsular contracture.
2.  If your implants are above the muscle and you desire to keep them there, you may benefit from the use of a textured implant.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Firmness is the hallmark

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I cannot tell for sure if you have a contracture.

Essentially, a contracture is a build up of dense scar tissue around the implant that can cause the breast to become hard, deformed, and even painful.

The first thing to do is to determine if the breast is soft or not. If you have diffiulty, go to your doctor. It may be a little difficult for you to determine, as it appears that you have a considerable amount of breast tissue.


You need a breast exam to detect capsular contracture

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If the left breast feels firmer, you may have a capsule. However, if the breast is soft as you say, then a capsular contracture is unlikely.

I do see the slight amount of fullness above the breast on the left side. This could be an early capsule holding the implant higher, or the pocket for the left breast implant that was created during surgery may have been a little smaller or higher than the pocket on the right-this would hold the right implant a little higher and create the fullness you see hoigh on the left side.

Your surgeon can determine this during the exam.

Hopefully with time, if you do not have a capsule the left implant will drop more, but after 6 months this is less likely.

There is more to this than capsular contracture

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It is difficult to tell if you have a capsular contracture without feeling the implants, but typically when one does, there is migration of the implant upward toward the clavicle.

Other explanations for your breast's appearance are:

  • The left breast pocket was not made low enough to begin with
  • You have a degree of sagginess to your breasts that would require a breast lift

This could explain why it looks like your breast is falling off the implant, especially on the left side.

Ask your surgeon to reevaluate.

Leslie H. Stevens, MD
Beverly Hills Plastic Surgeon

No, it is unlikely capsular contracture

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Hi!   I think your left breast is larger and more sagging.  I don't think exercise has anything to do with this.  At some point, you may want to consider a breast lift.

You might have a little capsular contracture, but that's not the main problem.

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

Make your life simple, see your doctor

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Over the internet I can not feel or see your breasts - one picture does not make a diagnosis -- be kind to yourself , see your plastic surgeon.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

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.