7 weeks post op, Is This Capsular Contracture? (photos)

I've had a surgery over 7 weeks ago,2nd one,got 400HP in left breast,and 375HP in right one,due to small assymetry.My left breast healed well.Right was difficult,bleeded more,and there was a swelling on the right side of the breast(bottom part below armpit)that was soft at the beginning.When I squeezed it with my hand it felt like some fluid.It hardened with time,after few weeks it's better.I found a swelled vein under right one. 2 weeks post op right breast appeared smaller,and it's still so.

Doctor Answers 13

Capsular breast implant contracture capsulectomy breast implant

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Dear Violet,

Seven weeks is too early to tell if you're developed breast implant capsular contracture. I would suggest you consult with your plastic surgeon. I would suggest breast implant massages twice a day and you may want to try some Singulair.

It is true that fluid and hematomas can lead to breast implant capsular contracture. However, swelling and fluid are very common after breast augmentation surgery. Breast swelling usually decreases 6 to 8 weeks after surgery.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 254 reviews

Capsular contracture after seven weeks

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Capsular contracture causes the breast implant to become firm and round up within the breast. An early capsule can be felt with drawing and firmness, and a later capsule becoming visible with distortion of the breast. What we note in your photo is that one of the implants is low with a pocket below the natural fold. The high profile implant is now projecting below the nipple causing the nipple to appear higher on the one breast. We don't think massage will get you anywhere. Wait at least six months and if you cannot live with the asymmetry a revision is in order.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

7 weeks is too early to diagnose a capsular contracture.

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At 7 weeks swelling the breast after augmentation might make the breasts appear to be suffering from capsular contracture.  Whereas the capsule that forms around all implants is visible after a few days, capsular contracture usually does not emerge for several months at the earliest.

Is this capsular contracture?

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You mentioned this was a 2nd surgery.  Redo's can be more difficult than primaries. What is the sequence of the photos that you have posted?   At 7 weeks post op, it is too early to identify a capsular contracture.  Your right breast doesn't look bad.  Your left breast is  bottomming out, and that may be the reason for your current asymmetry.  You should be massaging the breasts  daily.  The right side may still drop so that is looks more like the left.  When an implant bottoms out, it may actually look larger and this may be why the opposite side looks smaller to you. The other reason it may look smaller is that it may not have needed a smaller implant in the first place.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.8 out of 5 stars 19 reviews

Is this capsular contracture?

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based on your photo, it appears that the right breast is in fine position and that the left breast is too low. they both appear slightly  "shrink wrapped". this could be a subtle early contracture. your history of bleeding and swelling make me suspicious. there are some non-invasive strategies to employ.talk to your surgeon early. but I fear the left breast will be the problem as generally a low breast only gets lower. if it does bottom out another surgery to re-create the inframammary fold will be necessary. sometimes a cellular dermis is required and if this is your third operation I would recommend it. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Capsular contracture

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Dear Violet,

Thank you for the pictures.  There are several possiblities that may be considered at this time.  From your pictures it appears that the fold below your breasts (inframammary fold) are not at the same location.  After 7 weeks the implants should have started to, or should already descended into the appropriate anatomical location.  The issues that you had with your R breast may have impeded the descent expected, and/or possibly have caused the formation of a capsular in the area impeding the descent.  The other possibilities are that the implant on the L has descended and the one on the right still has to do so; also the surgical dissection of the L breast inframmamary fold might have been lower than the dissection on the right.  All of these are possibilities.  As always I suggest you see your surgeon as soon as possible as simple massage to ultrasound therapies can be used to help with the issues that you are currently having.  Good luck.

Ernesto Hayn, MD
West Palm Beach Plastic Surgeon

How to tell a capsular contracture

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A capsular contracture can range from something fairly minor that can only be felt to being as serious as something that is visibly distorting the breast and painful.   The body takes time to develop a capsule around an implant and if a contracture develops that also takes time, usually at least three months. 

At seven weeks, its too early to tell, swelling may still be a factor.  After the swelling has resolved and and adequate time for healing given, a physical exam is necessary to feel the capsule and determine if contracture is present.   Implant displacement exercises are often recommended by many surgeons to keep the implant mobile on the chest wall and possibly prevent contractures from developing.  If your not doing them, this may help soften them up in the early weeks after surgery.

Mild assymmetries are also expected as there are no two breasts that are exactly the same.  Be assured that 99% of observers besides you are unaware of these differences unless you point them out and the 1% that are aware, probably don't care.


Adam Hamawy, MD
Princeton Plastic Surgeon
4.8 out of 5 stars 57 reviews

7 weeks post op, Is This Capsular Contracture

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It's quite early into your healing. Hence, it's not likely you are experiencing capsular contracture. Your #healing will continue for 2-3 months for the early period. This includes some #swelling, bruising, malposition, color differences and sensation will be abnormal. Scars will also be changing and asymmetry is not uncommon as each breast heal at different rates before reaching the final result. The use of #Singulair and Vitamin E may also be of benefit. 

But, it can be up to one year see your final result. Your doctor may require you to move or massage the implants within the breast pockets during the #postoperative period. (#Textured implants do not require breast massage.) You must have patience as you heal and if there are any causes of concern, ask questions of the doctor or the nursing staff. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

See your surgeon

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Capsular contracture is when the tissue around your implant tightens, and this is what squeezes the implant to make it feel harder. If you've just recently noticed that your breasts have changed in shape, feel, and how they project from your body, then you're right - you could be developing capsular contracture (while it is early there is still a chance you may have developed it). While you can feel for yourself for any changes that indicate capsular contracture (signs include hardness, swelling, pain, and a rounder, more ball-like shape), please book an appointment with your surgeon who may examine you to see if it actually is.  The sooner you do this, the sooner you can be diagnosed and treated. Earlier detection is always better.

Treatments for capsular contracture include medications, therapeutic massage and stretching, as well as implant removal/replacement. Good luck!

Capsular Contracture Diagnosis?

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It is hard to make this diagnosis in the early stages based on photos.  I would recommend visit with your plastic surgeon.   Thank you for your question.  Capsular Contracture is one of the main risks of breast augmentation.   Classic signs are:

1.  hardness/tightness of the implant
2.  change in implant position (typically migrates towards the collarbone)
3.  increased pain and stiffness on the associated side.
Based on your description, you should see a board certified plastic surgeon for evaluation of capsular contracture.    If present, I would recommend a capsulectomy (removal of scar tissue) and implant exchange. 
Factors to consider:
1.  If your implants are above your muscle, you may want to consider switching to underneath the muscle, which lessens the risk of capsular contracture.
2.  If your implants are above the muscle and you desire to keep them there, you may benefit from the use of a textured implant.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 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.