Should I get 2nd opinion on treatment/capsular contracture after hematoma? (Photos)

Question

I developed a hematoma in my right breast day after initial surgery. Had another surgery and wore a drain for about a week. My doctor prescribed me Singular about 3 months post op, as signs of capsular contracture were starting to arise. I am now almost 6 months post op and have developed an infection of my incision as well as a confirmed capsular contracture in my right breast. My plastic surgeon scheduled another surgery for me this week, plans to use same implant. Should I get second opinion?

Alan Gonzalez, MD, FACS · Answer

Hello @Nurturing496553 As a plastic surgeon, I often tell my patients that it is wise to get a second opinion when considering any type of surgery. This is especially true when it comes to revision surgery, especially with what happened in your first surgery. Be wise when it comes to plastic surgery. It can change your life for the better or for the worse. Best wishes! Alan Gonzalez MD, FACS.

Gianfranco Frojo, MD · Answer

This is an incredibly complex problem that likely requires removal of the capsule around the current implant and replacing with a new implant. I would recommend seeing a board-certified or board-eligible plastic surgeon with aesthetic surgery training and experience to tackle this type of problem in a safe and efficient manner. Best of luck!

Chul Hwan Seul, MD, PhD · Answer

Thank you for your question. No, you shouldn’t use the same implant and get augmentation surgery before treating the infection completely. If there is a definite bacterial infection, it is desirable to remove the implant, remove the infected capsule and tissues, and then treat with antibiotics to completely resolve the infection, and then insert the implant again after at least 6 months. The opposite side also has severe capsular contracture, so it would be better to remove the capsule with the implant on the other side as well.

Ronald J. Edelson, MD · Answer

If you have an infection the implants need to be removed. If an implant is placed again it will get infected. You need to let the infection resolve for six months and then decide where you want to go from there.

John Michael Thomassen, MD · Answer

I am sorry you have had these complications.  Now you appear to have necrosis of inframammary fold skin and extrusion of the implant on the R side.  This area of skin will need to be excised.  It may be best to remove both implants and address the area of skin involved and let everything heal before placing new implants in.  Once healed and the scar matured, you can decide how to proceed.

Daniel Barrett, MD · Answer

Dear Nurturing496553,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Your implant is exposed, contaminated, and needs to be removed now. No, you cannot use the same implant. You will need to wait and let the tissue heal before getting a new implant replaced.  Both of your implants are too large and your frame and tissue, and you can downsize with the second procedure.

Darryl J. Blinski, MD · Answer

Yes but better yet appears in posted photo #2 you hae exposed implant! That needs to be removed asap!!!! Seek surgery, please.

Jason Pozner, MD · Answer

Both breast look bad. Get a second opinion. Most plastic surgeons would change the implant except if a minor capsulotomy is done. The 2 photos are not the best to determine what is going on

Mark Eberbach, MD · Answer

Second opinion. It is unfortunate that you had the problem with hematoma and infection. These kinds of complications are really tough on the patient and surgeon. They stress the relationship too.

It seems to me that using the same implant is not a good idea. I think most plastic surgeons would use an new implant.

Your pictures suggest a bilateral revision is in order.

Second opinions are often a good idea, but beware of trouble makers that may speak poorly of your original surgeon to boost their own egos.

Good luck

Should I get 2nd opinion on treatment/capsular contracture after hematoma? (Photos)

Answers (11)

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