Capsular Contracture After Breast Implants. What Are My Options Other Than Surgery? (photo)

I got my silicone implants ( 325cc both side) 7 months ago and both of them don't soft over time. My surgeon told me that it could be a capsular contracture grade 2-3, he told me to do a revision but I was so scare of having a surgery again. Is there any ways to help in my situation. Will the capsular get worse over time? And how much for the revision ? ( I don't want to ask my surgeon about that because I don't think he can help me. ) I'm so worried, please help me.

Doctor Answers 7

Capsular contracture?

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Based on your photos, it appears the right breast is slightly higher than your left.   A physical exam would be needed to determine if indeed there was capsular contracture.  All patients form a capsule around their implant.  When this capsule is soft, that's fine.  But in rare circumstances, if the capsule starts hardening, it can distort the breast shape and in severe cases cause pain/discomfort.   Depending in the severity of your condition, I might suggest aggressive massage therapy first for at least 3 months.  If there is no improvement or worsening of your condition, then a revision surgery will be required.  This procedure involves removal of that capsule (scar tissue) and placement of new implants perhaps in a new pocket (a virgin pocket with no history of scarring if it is available for use).  I would suggest you followup with your plastic surgeon to review your options. Hope this helps.

Dr. Basu

Houston, TX

Capsular Contracture After Breast Augmentation. Options Other Than Surgery.

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#Capsular #Contracture is a condition in which the capsule around the implant thickens and squeezes the implant making it hard and often changing the shape and position of the implant. It is more common in nicotine users (e.g. smoking or nicotine patches or gum). Effective treatment of the capsule frequently involves completely removal of the capsule (capsulectomy), and occasional incisions in the capsule may be somewhat helpful (#capsulotomy). In the past, closed capsulotomy, in which the breast is squeezed until the #capsule breaks, was used. Currently, most doctors avoid this technique because of complications associated with the technique and because the implant companies will void their warranty if this technique is used. At times it is necessary to change the position of the implant, either above or below the muscle, depending upon the initial position, changing the #implants themselves and, on occasion, the use of Acellular Dermal Matrix (ADM) may be required to prevent continued problems. Although the published risk of capsular contracture is approximately 9-11%, in our practice it is somewhat lower after initial implant placement. Once capsular contracture occurs, the risk of problems with secondary surgery rises to between 25% and 40%. The use of #Singulair and Vitamin E may be of benefit. If you had a Sientra Textured Implant placed as a primary procedure and a contracture occurs in the first two years after primary augmentation, then their implant warranty may apply.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Capsular contracture

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A capsular contracture can be confirm with CT scan so I suggest that you have the appropriate diagnostic tests before reaching the conclusion that hardness equates to capsules. The treatment for capsular contracture is removal of the implant and cleaning out the capsule, with or without reinsertion of the implant. Capsules typically worsen over time. I do not know why you think your surgeon cannot help you and would encourage you to return and discuss further with him. Revisional surgery is usually less expensive when performed by the operating surgeon than by a third party.

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Cap Con

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I do not rush to surgery on cap cons, the recurrence rate is really high. If it bothers someone than I operate, I have left patients with asymptomatic that means non painful cap cons for a long time. The non surgical options are not that great and are potentially damaging to the liver

Can Capsular Contracture be fixed Without Surgery?

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Other than having a revisional surgery the only thing that you could do is keep massaging the implants to soften them up some. 

Robert N. Young, MD, FACS
San Antonio Plastic Surgeon
4.6 out of 5 stars 73 reviews

Capsule contracture versus pocket issue

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If your either breast has become more firm over time and has changed shape then you may indeed have a capsule contracture.  If your breasts have essentially stayed the same the whole time in terms of shape and firmness it may be that the pockets created for your implants during surgery are too small.  Some patients have reported some improvement with certain medications for capsule contracture but this a rare event and usually happens when the capsule contracture is light.  Surgery would be the ideal process for correcting either issue unfortunately.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Capsular Contracture?

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From your photos, it appears that you have some degree of capsule on your right side - the left appears normal. This in combination with a firm breast is enough for a diagnosis of a capsule or an insufficient implant pocket. A revision surgery can correct both of these, but capsules can also return. Some surgeons will use a pill called Singulair as an off label means to try and remedy this problem. There is no need for additional diagnostic tests as the treatment remains the same. Discuss this with your surgeon as it is not necessarily anyone'f fault. A second opinion can be helpful if you feel unsure.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 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.