Capsular Contraction or Just Hasn't Dropped? (Photos)

Your pictures suggest severe superior mal-position of your right breast implant following breast augmentation with breast lift surgery. Displacement of this magnitude is an extremely unusual problem  in someone who's only five weeks post-op. The cause of this problem is unclear, but may be related to inadequate inferior pocket dissection or failure of the breast implant to drop into normal position. Capsular contracture would be unusual this early in the post-operative course unless associated with hematoma formation.It's important to understand that the period of time immediately following this type of procedure is characterized by dynamic change. During this period, muscles relax, swelling resolves, and the inflammation associated with wound healing slowly resolves. When these changes occur, the implants may slowly drop into normal position. This can be facilitated with a superior breast bandeau and massage of the breasts. If these maneuvers don't work, revisional surgery may be indicated, but this should be delayed for at least six months to allow adequate healing and resolution of swelling.A variety of methods have been utilized to minimize scarring following this type of procedure. Silicone sheeting appears to be relatively effective when utilized for this problem.It's important that you maintain close contact with your plastic surgeon. Your surgeon should be able to evaluate your condition and formulate a treatment plan that addresses your concerns.

Capsular contracture is probably not even biologically possible at five weeks. Swelling will artificially supports the volume of the breast implants which can mimic capsular contracture.

It is uncommon to see capsular contracture this early unless there was a complication around the time of surgery such as a bleed or haematoma. If this was the case it is possible that the problem is early capsular contracture.  Otherwise it is worth waiting to see if the implant does drop as the soft tissue loosens.I would discuss the options with the surgeon and this should make the way forward clear

All the best

Jeremy Hunt   

Your asymmetry is more likely due to post-operative tissue inflammation, combined with asymmetrical muscle tightening (that is if placed under the muscle).  "Capsular contracture" occurs as an overabundance of capsular scar tissue is formed around the implant. This occurs over several months, not weeks. You are best served to see your surgeon soon for a post-op exam and measurements, with recommendations on massage techniques that may correct this presentation before it heals as such.Best,Sergio Maggi, MD, FACSDirector- Austin Plastic Surgery Center

Thank you for your question and for the posted photos. Although the asymmetry is clear, without some preop photos it is hard to make any judgments. 

Five weeks is a little early for capsular contracture. That the implant feels "not as soft" could be consistent with either contracture, or with an implant that has not dropped, so that finding doesn't help sort out the diagnosis. 

The distinction really depends upon a physical exam, so seeing your surgeon is really the best way to get an answer to your question. All the best. 

It is really hard for me to know without physical examination and also it would be nice to see before photos. Being that said if the right breast is firm and hard then it likely is a contracture. This can happen as early as a few weeks post op. I would go see your surgeon. If it is a contracture there are things that can be done.

Sorry for your issues. Only revision will address the problem. But 5 weeks still to early in healing. Best to seek additional in person evaluations. 

Your concerns about the existing breast asymmetry, based on the photographs, are understandable. Clinical examination would be necessary to help differentiate between early signs of encapsulation (capsular contraction)  versus a higher position/sitting breast implant. Your plastic surgeon will be your best resource in this regard.

 Regardless, continued patience and time are your friends.  Hopefully, the breast implants will “settle” more symmetrically and you will be pleased with the outcome of the procedure performed.

 Your plastic surgeon will also be your best resource when it comes to this incision line care.

 Best wishes.

You do have a fair degree of post operative asymmetry but without a pre-operative photograph it is difficult to judge if this was expected or not.  In any event you are still very early in the post operative recovery and things will definitely change over the next few months.  If not then you may need a revision.  Follow your plastic surgeons instructions and give it time.  

At five weeks out, you have to give it more time to heal and settle. If the implant does not come down, you may need a revision.