Capsular Contraction or Implant Hung Up? (photo)

Had BA done last year 375 HP saline under the muscle. My PS took off 4 weeks after my surgery. I was told by 1 plastic surgeon my implant was hung up and pocket over dissected, the wrong size implants for my chest width. Another PS told me that I had mild Capsular contraction. The implant is soft and moves well. Does it appear to be over dissected or capsular contraction?

Doctor Answers 6

Breast Asymmetry

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Differentiating between a capsule contracture and a malpositioned implant can be difficult. Typically, capsular contracture is a progressive process whereas implant malpositions do not change over time. The treatment of both is the same- re-release of the pockets to better position the implants. 

Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

If Your Implant Is Soft And Moves Well, There Is No Capsular Contracture

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Capsular contractures are excessive scarring around breast implants.  Usually, the first sign of a capsular contracture is that the implant starts to feel firmer and firmer.  The second sign is that it stops moving very well in the pocket.  If your implant is soft and moves well, then you don't have a capsular contracture.  That possibility having been eliminated leaves you with the possibility that your left implant is hung up either by a scar band or because the implant was always higher on that side.  Since the left nipple has a slight downward tilt, I think your plastic surgeon can lower the inframammary fold on the left, and get you a better positioned and more symmetrical appearing chest.  I know it is always confusing having plastic surgeons give you different answers, but there again, that is the nature of plastic surgery. 

I would recommend you go back and see your original surgeon and give him or her the opportunity to diagnose your problem and treat it.  Whoever did the original surgery will have a better understanding of what may have happened and how to correct it.

Fixing breast implant asymmetry

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Breast implant asymmetry may be corrected by repositioning the implant and releasing or tightening the capsule formed around the implant.  Usually, these procedures can be performed in an outpatient setting. If you are unhappy with the position of your implants, breast implant revision may be an option.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Fixing breast asymmetry

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Your photos show left right breast asymmetry. I think this is related to the dissection pockets rather than capsular contracture because the edges of the implants are not very visible. You corroborate that by stating that the implants are soft and move well. Your breast creases are at different levels with the left higher than the right. I suspect there was some asymmetry present before surgery (with the left breast smaller and higher up than the right) which accounts for most of the difference in the dissected pockets. The question is what can you do to make them more symmetric and that would depend on what they looked like before surgery. I suspect you will need a slightly larger implant on the left and repositioning of the crease on the left and that if not for preoperative asymmetry you would have had a nice result. These procedures would best be performed by your original surgeon.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Implant issues

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It is best to go for an exam. The photos are difficult to see exactly and certainly an exam to feel the breasts will give more information.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Appears to high !

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This may be due to insufficient lowering of the inframmary fold or an early capsular contracture .You should have a good exam and a board certified plastic surgeon should be able to tell you.

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.