Advice on Fixing Capsular Contracture in Right Breast?

I had breast implants in June 2006. Before I had my implants put in, I was very asymmetrical. I had implants put in 600cc's on the right and 475 cc on the left over the muscle. I now have a grade 3 capsule on the right. I have had 3 consultations, and 2 of the surgoens want to put in silicone and go bigger. The other one wants to fill the left to 600cc's, put in a new implant on right, and fill to 725cc's. My nipples line up, so no lift is required on left. Implants are too big to go under now. I want to have them redone ASAP!

What would your opinion be? what would you recommend if you were my PS?

Doctor Answers 3

With a capsule on an implant above the muscle consider going below with a textured device

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The treatment options for patients with capsular contracture may involve thinking in terms of "trade-offs". It is pretty universally believed that in patients undergoing surgery for capsular contracture with implants above the muscle the chance of recurrence is less if new implants are placed beneath the muscle. Also if patients have smooth surfaced devices changing to a textured device may help reduce recurrence.

With the size of the devices you currently have and the suggestions you mention i would suggest seeking additional opinions from plastic surgeons who have significant experience in management of capsules and revisionary surgery. Be prepared to hear that you may need to go down in size.

Los Angeles Plastic Surgeon

Change the position of the implant and change the implants.

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Sorry to hear about your problem. Most PS agree that if you've developed a Baker III capsular contracture, surgical treatment should include removal of the scar capsule (capsulectomy), implant exchange (possibly to silicone gel) and conversion to another plane, in your case, on top to below the chest muscle.

Implants which are considered large > 600cc are associated with higher rates of implant shifting and capsular contracture. Consider defining your cosmetic endpoints and find a PS who will help you achieve them. good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 59 reviews

Going bigger over the muscle with silicone may give more contracture

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Contracture relates to the choice of a silicone gel and relatively little tissue to cover pretty large implants. You likely need a capsulectomy and new implants. If you go with large "Overs" again, it will likely recur. It sounds like you need more opinions.



John P. Di Saia, MD
Orange Plastic Surgeon

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