Breast lift and aug resulted in a capsular contracture and still saggy breasts. Should implants be removed or replaced? (Photo)

I had a breast lift with a 200cc saline implants put in 8 months ago . Terrible results. I have a capsular contracture in one of the breasts and the other feels as though it is sliding under my armpit. Both are still really saggy and have the appearance that my real breasts are hanging from implants. I am 5"7 and 126lbs. I have always had size D to DD breasts. It is not my intent to have bigger breasts. I would like smaller. Recommendation for the least risky surgery with the best results?

Doctor Answers 7

Revision of breast lift and possible capsular contracture

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As others have stated, you need to be examined for proper opinions to be given, and the photo technique leaves many questions.  Standard photo poses would help.  If you truly have a capsular contracture, as opposed to an implant that simply never dropped, you may need capsulectomy and you may want to consider removing the implants and just keeping your own breast tissue for the small volume breasts that you want.  You can find more discussion about capsular contracture elsewhere.  If it's just a malpositioned implant that never dropped because perhaps the pocket wasn't dissected enough, a capsulotomy should bring it down to the proper position.  If you want small but firm breasts, and you have recurrent skin/breast tissue laxity, a revision lift along with removal of some of your native breast tissue may be necessary.  Some women with poor breast tissue turgor and skin that pulls away easily from the underlying breast tissue have better results if that skin and tissue is reduced.

Capsular contracture and results

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It is difficult to tell from the photos all the issues you are describing. An exam in person would be essential to offer advice. If you have a CC then you would probably benefit from implant exchange, capsule removal and potentially a few other maneuvers.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Capsular Contracture and Sagging Breasts

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I understand how frustrating it can be to have not just one but two or three problems. In your case, capsular contracture on one side, implant malposition on the other, and persistently loose skin in both.  My recommendation is don't give up!  It is difficult to tell by photographs, but there doesn't appear to be anything inherently wrong with the work, but you can always get a second opinion with a revision breast expert.

I think that implants will help you get and keep the fulness you need in the mid and upper poles of your breast without imparting too much size, so they are important to keep and should be addressed.  On one side you have too much scar tissue, on the other not enough. Treatment would be catered to each situation.  A total capsulectomy and replacement implant is important to perform to minimize recurrence of the CC.  On the other side, capsulorrhaphy or pocket tightening will reposition the implant that has drifted off to your armpit. Finally, a revision lift will tighten up the recurrent loose tissue. 

Even though a lot needs to be done, and you are coming from a place of problems, usually a second surgery is enough to give you a great, long lasting result.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Remove or Replace...That is the question.

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I am sorry to hear about your difficulties with your implants.  This is a very complicated question and is best answered during a consultation with a board certified plastic surgeon.  There are so many important questions I would like to ask you.  You said you were always a D or DD. Based on the photos you are a lot smaller. Did you have implants before? Any previous history of capsular contracture? Are your implants on top or below the muscle? 

If this was your first augmentation and the implants were placed above the muscle, then replacing them with textured silicone implants, below the muscle would be your best option for replacing them. If you have had prior capsular contractures and you are willing to have small breasts, then remove the implants and do a revision of the breast lift.

Breast implants are a wonderful way to enhance your breasts but they do have issues. Capsular contracture and leaking are the two big ones.  If you can be happy without implants then this would be the "least risky surgery with the best results".

Michael Zarrabi, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 73 reviews

Problems with implants

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Although I can tell there is a problem, the photos are not posed well enough to offer specific advice. If you look to the right of the screen under featured doctors you will (probably) see properly posed photos. They should show the entirety of both breasts and have similar size (same distance from the lens). 

If you want smaller breast and have had the problems you are having with the implants, it seems obvious that part of the plan should be to remove the implants, and then possibly a revision of the lift itself.

Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Capsular contracture after breast lift and augmentation

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Capsular contracture can cause deformity after breast implant surgery.  As the capsule tightens, the implant can move up and the breast tissue falls off the implant more.  It is hard to tell from the photos, but it looks like you do not have a lot of native breast tissue and still have loose skin.   It is best to talk with your surgeon about options, or another board-certified plastic surgeon who performs a lot of breast implant surgery and revisions. 
You will need to decide if you want to keep breast implants in, or just remove them and likely revise the lift.    This decision isn't going to be easily made without talking with a surgeon who can analyze your breasts and discuss options and realistic expectations. 

Best wishes,

Dr. Michelle Spring

Breast lift and aug resulted in a capsular contracture and still saggy breasts. Should implants be removed or replaced? (Photo)

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Thank you for your photos and question.  If you felt that you had enough volume before the surgery, then I would suggest removing the implants and revising the mastopexy (breast lift).  It does not appear that enough skin was removed during your first surgery to give you your optimal results.  I would recommend viewing before and after photos with any potential surgeon that you are considering, as this surgery can vary in different surgeons hands. Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

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