Capsular Contracture, Leaking Fluid 11 Months After Breast Augmentation - Normal? Cost?

Capsular contracture comes in several grades.  If the capsule is firm and changes the shape of the breast then surgical intervention is usually necessary.  If pain is an additional component then surgery is definitely warranted.  Regarding the nipple discharge, if the discharge is clear-yellow then this may represent a seroma. Seroma can be detected clinically or with ultrasound.  11 months after the procedure a seroma should be treated before it becomes an infected seroma.    If the discharge is thick and yellow then this may represent a low grade infection of the nipple and ducts of the breast.  This needs to be treated differently usually with antibiotics. Regarding insurance coverage for revision of a cosmetic procedure, insurance companies usually will not cover these procedures.

Dr. ES

When someone has capsular contracture and possibly fluid build up around the implant, it can lead to some nipple discharge.  Sometimes it is simply from the increased pressure on the nipple area.  Other times it is the actual fluid being pushed out.  Either way, while possible, it is not very common.   To say otherwise is misleading.   For most women, if they get to the point where they are seeing a difference in the shape of the breast, then massage and/or Singulair will not have much effect.  You probably need to have a revision where the scar tissue is removed, and possibly change to a different implant, different pocket, etc.  Insurance covergae is spotty since it is a cosmetic surgery, but it doesn't hurt to check.  I hope this helps.

Without photos or preferably a face to face examination and details of the surgery no surgeon can give you detailed specific answers to your case. We do not know what type of implants you have (silicone or saline) or their position or the severity of the contracture. You describe 2 problems the capsular contracture and the yellow fluid coming out of the nipple.

The vast majority of breast augmentation patients have some degree of capsular contracture. It is only the more severe degrees with symptoms whose treatment would be covered by health insurance in which they only pay for capsule removal and they do not pay much. The less severe degrees of contracture are not associated with symptoms and only detract from the appearance. Their correction is cosmetic and not covered. 11 months is a little early to have revision surgery and may start you down a path of repeat surgeries because each surgery including capsule removal to some degree stimulates the scar formation response. Only get additional surgery if you really need it.

The fluid leaking is a separate issue but may have been caused by the same thing that caused the contracture. It could be a late seroma that occurs distant in time after the initial surgery. This is more common with textured implants (friction irritation) or with some trauma to the chest some point in time after surgery. The best way to noninvasively prove the existence of a seroma is ultrasound or MRI. If a seroma is detected it will need to be drained and the implant may have to be removed at least temporarily along with the capsule.