How Long Does Swelling Last After Open Capsulotomy?

I had a second revision on right breast on March 17. It is still swollen and I have a small lump in the right upper outside that I noticed yesterday. I was instructed not to massage for 3 weeks, but am concerned about scar forming before that. Any thoughts? How long does the swelling last? Thanks in advance!

Doctor Answers 13

Capsules and swelling

After a capsulectomy or for that matter any surgery  will leave residual swelling for several months after surgery.


New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Major swelling gone, 4-6 weeks.

Patients undergoing capsulotomy can anticipate significant swelling in the immediate post-operative period.This swelling resolves quickly with the vast majority being gone in about three weeks.Almost all of the visible swelling is gone in 4 to 6 weeks, but small amounts of residual swelling may be present for up to 3 to 4 months following surgery.
Compression bras and dressings are frequently used following capsulotomy to minimize swelling.Swelling can add to a patient’s post-operative discomfort.It can also increase anxiety regarding breast size immediately after surgery.
For these reasons, we feel it’s important for the patient and surgeon to have good communication regarding this topic immediately following surgery.In this situation, a little reassurance can go a long way towards making this a more comfortable experience.

Upper Breast Lump Following Revision

Postoperative swelling, especially after capsule procedures can last several weeks.  This lump could be a collection of blood or fluid, or even a reactive lymph node.  In the presence of swelling, it may be difficult to ascertain the nature of this lump.  Nevertheless, I recommend visiting your surgeon promptly, especially if this lump increases in size quickly.  

Brian M. Braithwaite, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 4 reviews

You didn't mention having a drain

It is not my practice to use drains for primary augmentations but I do use them frequently in capsulotomy and capsulectomy patients. I am usually surprised how much they drain and I am always glad I used the drain. I will bet you have fluid around the implant. This might be absorbed by your body or it might need evacuation if it is more than a small amount. An ultrasound would help to determine this. They could also drain it under ultrasound guidance to protect the implant. Much fluid, left around the implant, could incite the beginnings of another capsular contracture.

Most capsulotomy swelling should be gone within a month

Some swelling after capsulotomy is expected, but usually most is gone after about a month.

Scar tissue formation would not be dependent directly on massage.  The massage will help keep the pocket open and stretch the spasm muscle.

Capsulotomy swelling can last a few weeks or more

Hello,

Swelling after surgery can last a while and it is difficult to know without knowing more about your case. Some of these cases are simple and others require more surgery. The longer operations tend to have swelling that takes longer to subside.

The capsule will not recur in such a short period of time. It takes longer to form.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 26 reviews

About Healing Post Augmentation and Capsular Contracture

Patients will feel #sore and tired during the first 48 to 72 hours following surgery. During these first few days, you may engage in light activities, but must refrain from lifting or raising  your arms above your head.

Swelling and bruising will subside during the first week after surgery and can be managed by pain medication. The initial surgical tapes will be removed a few weeks after surgery during a post operative visit. #Revision patients typically may return to a work a few days after surgery (only a light workload during the first two weeks). Showers are permitted on post op day three if there are no drains.
Scars will progressively fade throughout the first year following surgery and products may be applied a few later but only with your surgeon's permission.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Swelling Post Capsulotomy

Thank you for your inquiry.In general, capsulotomy tends to have less swelling than capsulectomy but it is still normal to have swelling after the procedure.The majority of the swelling will go away after about a month or so, but it can take up to a few months before the swelling is completely gone.As for the massage, I would most definitely follow the advice of your surgeon for this.I hope this helps.

Eugene Kim, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 52 reviews

Too early to tell

PK,

At 10 or 12 days out from your surgery it is too early for you to develop a new scar contracture.  The small lump may be a lymph node that is reacting to the trauma of surgery.  Follow up with your surgeon for updates on your progress.  Good luck!

Too early for a recurrence

It is possible that the lump that you are feeling is swelling in the breast tissue itself and not related to the formation of a new capsule. At 10 days the breast would be expected to be firm but it is unllikely that an abnormal capsule is already reforming. If an extensive capsulectomy or capsulotomy was performed then post operative swelling is expected. Your surgeon is in the best position to determine the next appropriate step for you. He understands where the capsulotomy was performed and what physical findings are normal and which are abnormal.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 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.