Timeline for capsular contracture detection in subglandular augmentation vs. submuscular augmentation?

I was wondering if CC can be detected sooner in subglandular breast augmentation than submuscular breast augmentation. What treatment is provided and when does it become too late to treat? If a patient with submuscular breast implants calls in at 12-16wks post op complaining of tightness and an implant much higher on one side. Do you have them come in right away to examine and treat? As always thank you so much for your response. Your time is greatly appreciated!

Doctor Answers 4

Timeline for capsular contracture detection in subglandular augmentation vs. submuscular augmentation?

Capsular contracture can be detected by exam equally as well in either implant location but usually does not occur until 4-6 months after surgery.

I ask patients to see me immediately if they feel firmness. Early intervention is important.

Capsular Contracture

Thank you for the question.

The location of the implant (above or below the muscle) does not affect how quickly you can detect capsular contracture.  As far as  prevention and treatment, this is one of the most studied phenomena in aesthetic breast surgery.  There are numerous studied techniques suggested for prevention (implant type, implant pocket placement, steroids, high dose vitamins, massage, among others) but even the data on many of these prophylactic measures are equivocal.  To date, there is no effective treatments beyond surgical revision.  

Hope you find this helpful!

Capsular contracture

Capsular contracture is more common with the implant in the sub glandular than submuscular position. It is easy to discern capsular contracture in either position. We usually don't see capsular contracture until  at least 4 to 6 months has passed since surgery. For my patients if they would complain of tightness I would certainly see them and start them on some nonsurgical therapies such as the z-wave acoustic sound wave or pills such as Accolate. Should neither of those be effective, than a surgical option such as capsulotomy or capsulectomy and maybe placement of an ADM like Strattice would be considered. Discuss this with your plastic surgeon. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Capsular Contracture

Hello,

Capsular contracture can be detected easily whether the implant is above or below the muscle. On the other hand, capsular contracture is more likely to occur in implants placed over the muscle.  Typically, capsular contracture becomes apparent anywhere from 2 to 4 months after surgery, however very early signs can sometimes preclude frank implant firmness or malposition, like asymmetric or more prolonged pain in one breast after surgery.  

Despite the strong desire to slow or reverse the process non-surgically, there is no reliable or significantly effective treatment for the problem, including the use of drugs like Singular or Accolate, high dose vitamin E, antibiotics, external ultrasound, or implant displacement techniques (massage).  Although virtually inevitable when a patient has this problem, I see them regularly even though I have nothing that can help them. At the appropriate time, 6 to 9 months, I will perform the definitive surgery.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

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