Capsular Contracture Under Pec Muscle? (photo)

I had a breast revision and lift 3 years ago - silicone implant under the muscle and alloderm. I massaged every day but I now have a capsular contracture that came on quite quickly which my doctor says is not affecting the implant pocket but is scar tissue under my pectoral muscle causing the muscle to be tight and making my one breast appear higher up and contracted laterally. He suggested massage and return in 6 weeks. How should I be massaging this and is it realistic to think it would work?

Doctor Answers 4

Capsular Contracture Under Pec Muscle?

Capsular contracture can occur with submuscular implants. This looks and sounds like one to me, but I have not had the advantage of an exam as has your surgeon.

As to massage instructions, , I would suggest calling your surgeon for the specifics. Absent that there are examples on Youtube.

All the best. I am quite guarded about chances of success. 

Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Capsular Contracture Under Pec Muscle?

       If you have capsular contracture, this tends to be progressive and massage will probably not have an effect on this.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Breast massage does not affect capsular contracture.

I recommend you do with your surgeon advises but I am of the opinion that massage is ineffective in preventing or treating capsular contracture.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Nonsense Explanations


Abnormal or tight 'scar tissue under the muscle' is capsular contracture by definition when the implant is also under the muscle.  Your photographs are suggestive of the diagnosis as well.

I think it is important for plastic surgical 'experts' like myself to try to give women the best advice possible, based on scientific evidence.  We experts walk a fine line when we answer your questions, between giving you potentially wrong advice based on limited information or poor quality photographs, and causing direct conflict between you and your surgeon.  However, I think it is important that certain issues have some light shed on them to 'let the world know'.  Implant massage does not prevent or treat capsular contracture.  This has been proven in prospective studies, and those of us who perform a significant amount of breast augmentation surgery and don't have our patients massage have as low or lower rates of capsular contracture as those who still have their patients massage.

If you are not happy with the appearance of your breasts, you should seek a second consultation with a revision breast surgery expert to establish a firm diagnosis and treatment plan (surgery).  Minimum requirements are certification by the ABPS, and membership with the ASAPS. Additionally, he should have a strong reputation as a cosmetic breast specialist, one who does lifts and reductions as well as implants.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 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.