Capsular contracture 1 week post-op. Could CC have been avoided with earlier massaging?

Had breast augmentation 3/25/16. Had follow up appointment 3/31. Was informed no massaging until one month. I was placed on pain meds. night of 4/4 began to feel pain/discomfort to right breast. began to harden/ tighten to the point it changed to cone-like shape. I iced it but then felt a sharp cold pain on my back shoulder blade area. I emailed office. Given muscle relaxers At 1 month appt, PS examined & said it was capsular contraction. Could CC have been avoided with earlier massaging?

Doctor Answers 11

Capsular contracture 1 week post-op. Could CC have been avoided with earlier massaging?

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Capsular contracture is unusual to occur so early. If painful breast is larger and you feel a lot of pressure could be hematoma.

If capsular contracture is going to happen it can happen even with breast implant displacement exercises so earlier massage would not have chganged things.

The other question is whether the implant pocket was made big enough. Has your surgeon suggested Singulair tablets?

Capsular Contracture

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Thanks for your inquiry.  It is a little bit unusual to have capsular contracture one week after surgery.  Typically when you experience pain at that point, in general, it has to do with muscle spasms, hematoma, or something like that.  Sometimes, capsular contracture cannot be avoided.  I am very sorry for your situation.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Capsular contracture

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11 days following surgery to form capsular contracture is very unusual.  Too early massaging can lead to pocket bleeding which can cause CC.  In my opinion, massaging early would not be wise. 

Christopher Costanzo, MD
Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 40 reviews

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Non surgical management of CC

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Non-surgical management includes prophylactic massage to prevent it and if it occurs, the use of certain anti-asthma medications: Singulair and sometimes Acculate as off-label FDA usage to treat Capsular Contracture and in some cases of recurrence of capsular contracture in a preventative fashion. In my experience this works best for early diagnosed early contractures and used as a prophylactic, perioperatively when doing a capsular contracture surgery


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usually do not form that quickly and what you described was more of a muscle issue (I presume your implants are under the muscle) as nothing makes the beast change as described except muscle contractions.  Massage is not known to prevent contractures but I'm doubtful that is what you have.  You can mention to your surgeon that your on-line searches were doubting of the diagnosis due to the early onset and see what he/she says.  If you have photos of what you were before surgery and right after surgery, it would be possible to provide some explanation of what you have going on, which in my opinion, sounds like implant malposition or an inadequately dissected pocket... but you still need to trust your surgeon as he/she should share you desires for the best outcome possible.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Capsular contracture

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 I'm sorry that you're experiencing some problems but it is very highly unlikely that you're having a capsular contracture.  There possibly may be something else that is wrong and should be carefully examined by your plastic surgeon. Perhaps there is blood or fluid in the pocket or the pocket is not large enough or the implant is sitting very high because the muscle is not completely released. Early  massage is usually implemented but is not the cause of your problem in this case. Best of luck to you. 

Capsular contraction one week after surgery

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It is impossible for you to have capsular contraction one week after surgery.  You must discuss this with your surgeon.

Malcolm A. Lesavoy, MD
Beverly Hills Plastic Surgeon
3.9 out of 5 stars 11 reviews

Massage Doesn't Prevent Capsular Contracture

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What you are describing is a sudden change in shape and size of your breast associated with pain, which is most likely a hematoma. You may still have residual blood or fluid in your right breast, and you are now definitely becoming contracted.  

This would not have been avoided by earlier massage.  In fact, regardless of the scenario, capsular contracture is not prevented by massage, and massage is not necessary for normal healing. 

Unfortunately, you will need a surgery to remove scar tissue and replace with a new implant. This should be done through an inframammary incision to prevent re-contracture.

Best of luck!

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

Capsular contracture or implant malposition

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It is always important to differentiate capsular contracture versus malposition; in one situation you can keep your implants and just need an implant repositioning. In the case of true capsular contracture, you will require implant replacement because the implant will have been contaminated with glycoproteins which harbor bacteria.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 106 reviews

Capsular contracture and massage

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It would be unusual (impossible IMO) to have CC that early.  I would get a second opinion as the source of the change is likely muscle spasm, hematoma, seroma, or a change in implant position.  

Regarding massage and contracture there is weak to no evidence that massage plays any role in preventing capsular contracture.   I would recommend following your doctors advice regarding massage but recognize that there are many of us who don't recommend massage to prevent capsular contracture at all.    

I used to require all of my patients to massage their breasts regularly starting at 3 weeks. I have seen no change in our contracture rates (less than 1%) since we stopped this practice several years ago.  

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 189 reviews

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