Breat Augmentation Revision Due to CC- What is the Best Option, Please Help

I had my first BA 2&1/2 yrs ago(Subglandular,285cc,Silicon Implants). The results were great.Just2months ago i started developing Capsular Contracture in my right one. Took anti-biotics and costizon,the breast softened but not for 2long. A month later the right Breast hardened again. Now i have decided to go for a revision surgery for both. My question is what is the best placement method if i want most natural look&less CC rate? Under the Muscle + Silicon + Textured + TearDrop Shape??

Doctor Answers 7

Breat Augmentation Revision Due to CC- What is the Best Option, Please Help

Sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.. In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix. Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin). I hope this, and attach link ( demonstrating a case utilizing acellular dermal matrix) helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Treatment options for capsular contracture

Capsular contracture can be difficult to treat. If your current implant is under the gland, changing the pocket to under the muscle will certainly decrease (but not eliminate) your chances of recurrent capsular contracture. Traditional teaching is that saline has a lower capsular contracture rate than silicone, but in Australia no one uses saline implants! Perioperative antibiotic therapy is important, with recent evidence suggesting that low grade implant infections can cause capsular contracture. The Brazilian polyurethane coated implants from Silimed have some of the lowest published rates of CC - another factor to add in to the mix. The final thing which I think contributes is size - make sure you the implant being used isn't too large for the soft tissues of your chest.

Capsular Contracture Best Option for Treament

If you implants are subglandular the best option is to put them under the muscle.  I don't believe saline or texturing helps that much, and in some cases can make it worse.  Sub muscular smooth gel implants are the way to go.

Mark A. Schusterman, MD
Houston Plastic Surgeon
4.9 out of 5 stars 77 reviews

Options for capsular contracture

This is not an easy answer but things that may be associated with lower capsular contracture include: under the muscle, textured, silcone, "no-touch", triple antibiotics, neo-pectoral pocket, inframammary fold approach, possible accolate therapy,etc.. Discuss these options with your surgeon.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Capsular Contracture and Implant Position

Research has not really demonstrated a substantial difference between textured and smooth implants with capsular contracture.  Going behind the muscle has shown a difference, as has the type of antibiotic irrigation used.

I would recommend going behind the muscle with smooth implant saline or silicone and pocket irrigation and maybe prophylactic use of Accolate (which is off label and no studies for its prophylactic use exists).

Use of acellular products may play a role in decreasing capsular contracture, as there is some evidence especially in radiation to resist or decrease the chances of CC.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 77 reviews

Capsular Contracture

There is really no way to prevent capsular contracture at the present time.  However, an implant under the muscle has  alower rate of capsular contracture. Also, textured silicone implants have lower rate of capsular contracture when in a subglandular plane than smooth types.  In a submuscular plane, there is virtually no benefit.  I would personally perform a capsulectomy, implant removal, and new submuscular implant placement. 

Siamak Agha, MD, PhD, FACS
Orange County Plastic Surgeon
4.7 out of 5 stars 106 reviews

Breast Revision for Capsular Contracture

There is no ONE way to treat and prevent capsular contracture. In your case, I would remove the implants, remove part of the scar tissue,wash the pocket with antibiotic solution and place new implants under the muscle where the rate of capsular contracture is much lower. There is increasing evidence that using an acellular dermal matrix such as Alloderm or Strattice along the lower, side portion of the pocket further significantly lowers the risk of capsular contracture. Dr. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 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.