If Capsular Contracture Comes Back, is It Usually Worse, Same or Better Than Before?

Usually, when a patient develops a capsular contacture, it is a good idea to change SOMETHING when you take out the capsules to try and minimize the risk of a recurrence.  There is a higher incidence of capsular contractures when implants are placed above the chest muscle than below it.  I believe this is due to better blood supply, less exposure to possible contaminants, and the massaging action of the muscle.  I don't have any statistics but, based on my experience, I would say that there is a good chance that you will develop a capsular contracture again at some point.  My best advice would be vigorous massage and, if it looks like you are developing firmness again, warm compresses, Vitamin E or Accolate (whatever your doctor likes to use), and possibly a course of antibiotics if there is a suggestion of an infection as the cause.  If you DO develop a capsular contracture again, I would suggest submuscular placement of your implants the next time around.

It is impossible to say that anything is a100%. Saline or silicone implants placed in a subgladular position have a higher chance of getting a capsular contracture than implants placed in a submuscular position. Though, since you are a revision, you are at a higher risk of capsular contracture. In medical studies the incision has not been shown to affect capsular contractures statistics too much. I would say that you are at an increased chance of developing capsular contracture based on your history of having developing capsular contractures. If you need a further revision I would suggest using silicone implants in a submusclar position.

CC recurs regularly enough that we, as plastic surgeons, tell patients that it is probably at least a 50/50 chance, at least I do.  There is just no way to predict.  I personally feel that subglandular implants have a higher chance of CC, and of recurrence, ESPECIALLY if the capsule is not completely removed. I use mostly implants with "smooth" shells (rather than "textured") so I advocate that patients "massage" the implants (move them) starting 1 week after surgery.  Seems to keep CC rates very low in my practice.