Is This Capsular Contracture? If So, What "Baker" Grade? How Long to Take Singular?

Not knowing what you started with or exactly what was done at surgery it is impossible to say how/why you ended up with this result. The posted photo shows asymmetric breasts with the left nipple lower than the right, the whole left breast hanging lower than the right including the contents of the skin envelope. I suspect the left inframammary fold is lower than the one on the right.  It is very likely that you were asymmetric before surgery even though your description makes it sound like you developed the assymetry in the months following surgery. In that case the surgery magnified the asymmetry. The only certain thing is you will need further surgery to improve the symmetry and taking Singular is a waste of time and money. The appropriate surgery could include capsulectomy, skn excisions to reposition the breasts etc. depending on the physical findings and history.

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.

Singulair is used as a FDA off label usage to treat Capsular Contracture and in some cases of recurrence of capsular contracture in a preventative fashion. This does not apply to you for the following reason: Although capsular contractures following breast augmentation can occur just about anytime, most women start having symptoms around three months after their breast implant surgery. This is because it takes some time for a capsule to form and then to scar down (contracture). Therefore it is probably too early at 3 weeks to be concerned about this problem. Your signs and symptoms are most likely from muscle spasm although other factors could also cause this. Your plastic surgeon should be able to sort this our in short order.

Hello! Thank you for your question! Physical examination will determine if you have capsular contracture. The look and feel of hardness surrounding your implant is seen and/or felt. At its worst, you experience pain. It may also cause distortion of your breast. What has caused it will be in question.  Given your description, it sounds consistent with capsular contracture - but only an examination could determine. Grade is a physical examination necessity. Your surgeon will likely recommend implant massage and may add the medication Singulair. If these fail, surgical correction may be suggested. It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. Irrigating with certain medications may also be if benefit. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc). Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you.  Cost will vary with geographic area and would expect similar pricing your initial procedure, but discuss with your surgeon.  Hope that this helps! Best wishes!