Could I Have Capsular Contracture?

Almost four months ago I got BA saline unders 525& 515. I was massaging as my P.S recommended. But about three weeks I noticed that the right breast is higher than left. Is a bit firm than left. It doesn't hurt. I did go with my PS and was told to keep massaging four times a day, that this would help for breast to soften up. But I'm afraid that I won't. Can this be capsular contracture?

Doctor Answers 11

Possible capsule contracture 4 months post-op with saline implants under muscle

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With one implant higher than the left, especially if this is a new thing and wasn't there all along, and that same breast being noticeably firmer than the other, it is quite likely that you have an early or mild stage of capsule contracture.  It could also be that the breast that has the 525 cc may be a tiny bit firmer and more projecting than the one with 515 cc also, so you should note if the higher and firmer breast is the one with the more saline in it.  If this is capsule contracture, you should know that not all capsule contractures need surgery, and sometimes we can even cause the contracted breast to soften with certain medications.  Continuing to massage is also one of the things that could help the breast soften in the event of capsule contracture.  In the end, it is very difficult to make a conclusive diagnosis on the internet like this, so you should follow the instructions of your surgeon.  However, the symptoms you are describing, along with the time course, are suggestive of capsule contracture.

San Diego Plastic Surgeon

Capsular contracture vs. implant malposition

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It is possible that you have a capsular contracture or this could just be implant malposition.  You should follow up with your plastic surgeon for an evaluation. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Capsular contracture at three weeks

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At three weeks it is unlikely  that you have a capsular contracture.  Each side may settle differently.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

If One Breast Is Higher And A Bit Firmer, Could This Be A Capsular Contracture?

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Capsular contractures are an immune phenomena where your body is trying to protect you against the implant which is seen as an invader.  The two most common reasons for early post-operative capsular contractures are:  1) blood around the implant;  2) non-pathogenic bacteria around the implant.

Capsular contractures almost always occur on one side, and that breast is most often higher than the other side, and of course, firmer.  There are, of course, other explanations which must be considered.

1.  The higher breast may have been higher pre-operatively and it will never match the other breast.  This can be determined by studying the pre-operative pictures and measurements.

2.  The implant is temporarily malpositioned upward and can be brought down with gravity, no bra, and an ace wrap.  A few millimeters of upward malpositioning can be corrected in the subpectoral space, but rarely will it move down very far due to the coefficient of friction.

3.  The implant is definitely malpositioned and re-operation is necessary, usually secondary to one or two scar fibers not noticed at the time of surgery. 

Asymmetric firmness between the two breasts in the recovery phase, and even after many years, is not unusual.

Therefore, there are several possibilities for your high riding, firmer implant.  Here's where you need to speak to your plastic surgeon and follow his or her advice on the diagnosis and treatment.

Hard to tell without pictures and examination

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You may have mild contracture based on your description. Pictures can be helpful. Please continue to see your surgeon. The absence of pain in your breast is a good sign. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 148 reviews

Capsular Contraction vs. Malposition?

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Dear Liss,

Thank you for your post.  It sounds like you have asymmetry with one breast higher than the other, and you noticed this very early on.  This could be that one breats did not descend and the other did.  At 4 months, you basically have the shape that you will have.  However, a breast revision can give you good symmetry. 

Best wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 41 reviews

Capsular contracture

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It is certainly possible that you have a capsular contracture. But it could just be implant malposition or just an implant that has not descended into the pocket as fast as the other side. Capsular contractures tend to get worse with time, not better. Implants that are simply "high riding" get better with time. If you think that the implant in question is getting more firm and higher, then you probably have a contracture. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 87 reviews

Could I Have Capsular Contracture

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Thank you for submitting your question.  You may be experiencing early capsular contracture.  If it does not improve after 6 months then a revision may be needed.   Continue close follow up with your Plastic Surgeon.  Best wishes. 

See your surgeon

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This sounds like you may have developed capsular contracture since the firmness and higher positioning is new to you. Please return to your surgeon for another assessment.  

Capsular contracture can cause asymmetry after breast augmentation.

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A four months it is possible for capsular contracture to cause volume distribution asymmetry of the two breasts. Massaging the breast is not decrease the risk for capsular contracture as you are finding out.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 41 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.