What else do I need to consider with breast implants/augmentation? I'm scared of capsular contracture (Photo)

I'm a 28" bust, 24" waist, 35" hip, 110 lb 5'3". I'm not aiming for a "porn star" look, just something to balance out the hips and give me cleavage. I'm interested in submuscular implants because I'm not sure if I have enough natural tissue. I'm also concerned about capsular contracture, I want to choose an implant and type of procedure to minimize risk as much as possible. I'm interested in silicone for the softer,natural look/feel, but I'm concerned about silent leakage. Maybe gel matrix?

Doctor Answers 16

Choosing the best implant size for breast augmentation

In order to determine the best size, type and placement for your breast implants, you must consult in person with a board certified plastic surgeon. The best way to provide you with the information you need is for a surgeon to be able to examine you in person and let you "try on" different size and types of implants so you can see the sizing for yourself. In terms of capsular contracture, the best way to reduce the occurrence is to go to an experienced breast augmentation surgeon. A good surgeon will explain to you what he/she does in order to reduce the risk of capsular contracture. For example, keeping everything very sterile during surgery and using a technique that causes minimal trauma and bleeding are things that can be done to reduce the risk of capsular contracture. With that said, there is no guarantee that you will 100% avoid capsular contracture, and your surgeon should be open and honest about that with you. Choosing a qualified surgeon should lower your risk. Good luck!

Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

My considerations..

Hello. There are plenty of options with regard to size and shape that would look good on you. This will depend a lot on the result you're trying to achieve. Currently, the lowest risk of capsular contracture reported is with MemoeryShape breast implants 3.6% after 10 years.  I recommend the MemoryShape in my practice. Feel free to see before and after photos of this breast implant on my website. As far as getting to the details of sizing in my practice, this is how we do it:

1) My philosophy includes guiding patients to explore reasonable options for breast implant size, usually two to three similar sizes, which allows the patient to visualize how different volumes affect their breast cup.

2) The best guide for a final breast implant size recommendation is derived using measurements from the patient’s own breasts and chest.

3) When measurements are considered then options for sizes can be presented.

4) I use the Mentor Volume Sizing System of breast sizers to demonstrate how these different volumes will look on a patient’s body.

5) This methods offers good reliability and is simple to use, but is not perfect.

Bigger is not always better. Best,


Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 185 reviews

Breast Implants

Your concern  for capsular contracture is legitimate. I would recommend seeing a board certified plastic surgeon with extensive experience in breast surgery.  As the cause is relatively unknown there are several pre-operative, operative and post operative things that can help reduce the risk.

Arthur M. Cambeiro, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 132 reviews

Planning a breast augmentation

Thank you for asking about your breast augmentation.

It is natural to have many concerns before your surgery. Your questions are resonable.
  • Every surgery has risks - and capsular contracture is a risk with implants.
  • The risk on average is 1% a year - so a 10% risk at 10 years, 100% risk at 100 years.
  • Saline implants are less likely to cause capsular contractures.
  • The cohesive gel implants do not appear to leak - the older ones definitely did.
  • At your consultation, discuss all your concerns with your surgeon to decide what is best for you.
Always see a Board Certified Plastic Surgeon
Hope you found this answer helpful. Best wishes.

Implant considerations

It is important to be aware of the short- and long-term problems that can arise with breast implants.  You mentioned a few issues like contracture and rupture; it would be best to have a proper consultation because the risk of certain complications (like rippling or implant palpability) will vary depending on the person's body type.

The Perfect Breast

You are thin with relatively small but nicely shaped breasts. The keys are to fill out the upper and lower parts of the breast with the right implant and to place it in a way that looks relatively natural. The technique that best achieves this is a Dual plane technique, where the implant is below the muscle in the superior pole of the breast, and the lower portion of the muscle is released to allow the implant to fill the lower pole of the breast. This covers the implant sufficiently while allowing it to be in an ideal position and fill the breast envelope beautifully.

Location of the incision, location of the implant, type of implant, and size are all critical questions for women who choose breast augmentation. The common denominator to the most beautiful breasts is that they were sized objectively on the basis of measurements. For instance, we combine a proven formula based on measurements of the rests and chest along with through discussions of patient's desires. Photos of ideal breasts and results from patients with similar breasts are often very helpful in the discussion.

Breast implant capsular contracture concerns

Thank you for sharing. There are many ways plastic surgeons minimize the risk of capsular contracture. For most patients this may include: under the muscle, cohesive gel implants, using antibiotics correctly and using a funnel introduction device through an inframammary fold incision in addition to other operative techniques. Capsular contracture is higher with bleeding and bacterial biofilm which is different than the traditional infection that most doctors think about. Skin and ducts harbor the bacteria and minimizing the implants contact here is key. Seeing a plastic surgeon with experience is key here. Hope this helps- best wishes!

Breast augmentation consideration

Good job doing your homework as a breast augmentation has a lot of variables most don't realize. You are starting out in a good place with symmetric breasts and no breast ptosis or droop. You do not have pectus excavatum but you do have a few centimeter separation between your breasts as you mentioned and an augmentation will not improve this much. In a bra you can create the cleavage you may wish for but your breast position on your chest wall cannot be altered much. I would recommend silicone and although textured implants may have a lower capsular contracture rate the shell is slightly more palpable. I do use both textured and smooth depending on the patient. I definitely recommend a sub muscular placement of the implants. An incision through the areola does carry a higher risk of capsular contracture compared to an incision under the breast. You should have an excellent outcome with an augmentation if performed correctly. Best of luck

What else do I need to consider with breast implants? I'm scared of capsular contracture

Most of my patients just want to be balanced and proportional, so I think you have realistic expectations. Most women choose a silicone filled implant because it feels more natural. I think you have enough natural breast tissue to have an excellent cosmetic appearance after surgery. The risk of capsular contracture is low. It is decreased by placing the implant behind the muscle, by using cautery to minimize bleeding and by irrigating the pocket with an antibiotic solution prior to inserting the implant. Regarding the types of silicone implants, I think that is a topic best discussed with your surgeon. Good luck!

What else do I need to consider with breast implants/augmentation? I'm scared of capsular contracture

I think a textured silicone implant would be a good choice for you. My preference is Sientra implants. Reports of their risk of capsular contracture appear to be lower than the other companies and there is no silicone bleed like the older implants used to have. The degree of cohesiveness of their silicone is higher than the other two companies. You will have cleavage in a bra, but less so out of  a bra when placed under the muscle, but caspular contracture risk is much less in a submuscular position.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.7 out of 5 stars 21 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.