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

Post op 5 weeks. Ba and bl silicone 308 and 324. 324 higher and not as soft. Still have a little numbness when shave under arm on that side. Is this capsular contraction or has that breast just not dropped. Also concerned with incisions. Using Biodermis silicone sheets. Have some hardness around aereola scar , indentations and some cinching. What us the best treaemt for scars silicone, tape or other? Most concerned with size and shape and placement...

Doctor Answers 11

CC vs not yet dropped

At 5 weeks the implant usually has dropped into position so this may be early CC. Since surgeons almost always sit patients up during surgery to judge implant position, it is unlikely that they started that way. Have you discussed possibly trying Singulair with your surgeon along with upper pole implant compression to help it drop? If this persists without improvement after a reasonable trial of conservative treatment, it does look like a revision will be in order. 3 months is probably a reasonable minimum  time to wait. I believe that silicone sheets work best for scars. Best of luck.

Dallas Plastic Surgeon
4.6 out of 5 stars 39 reviews

Capsular Contraction or Just Hasn't Dropped?

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. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Superior Implant Malposition After Breast Augmentation With Breast Lift

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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Capsular contracture not possible at five weeks after breast lift with augmentation.

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.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Capsular contracture or implant drop

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   

Jeremy Hunt, MBBS, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 118 reviews

Capsular Contracture or Just Hasn't Dropped #breastimplants

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.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Capsular Contraction or Just Hasn't Dropped?

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. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Capsular contraction or implant asymmetry

If your breasts and implants looked symmetrical early after surgery and have changed over the last few weeks you may well be dealing with CC.

If there has been no significant change in breast appearance since surgery it looks like your implants are sitting at different levels.

I think you should go back to your surgeon so he / she can take a good look at the result and discuss the possible need for a small revision. It's probably best to let things settle a little longer before going back into the O.T.

Douglas McManamny, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast Asymmetry after Breast Augmentation/Lifting?

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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Post operative asymmetry issues following breast augmentation and breast lift

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.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 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.