1 year post-surgery and 3 weeks post-breastfeeding, one breast sits higher and is bigger. Is this capsular contracture (photo)?

I had my breasts done just over a year a go. I had an unexpected miracle or getting pregnant about two months after surgery. The results were awesome, until about two months a go, I noticed one sits higher than the other and is bigger. I was still breastfeeding at the time, so I thought maybe it had something to do with the milk. I have since quit breastfeeding about three weeks a go and it hasn't changed. Can you tell what is wrong and what needs to be done to fix it?

Doctor Answers 2

Capsular Contracture?

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Thank you for the question and picture.  Congratulations on the miracle child.

No, unfortunately is not possible to make an accurate diagnosis without physical examination.  Your new onset asymmetry may be related to changes in the breast after pregnancy  and breast-feeding or may be encapsulation.

Encapsulation refers to  abnormal thickening  of the breast implant capsule (also  referred to as capsular  contraction)  that can cause hardening of the breasts, displacement of the breast implants, and significant discomfort/pain.

It would be in your best interests to follow-up with your plastic surgeon for examination and advice.

I hope this helps.

Capsular contracture

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Capsular contracture is an abnormal immune response to foreign materials in the body.  It is graded on the Baker scale with symptoms as follows:

Grade I — the breast is normally soft and appears natural in size and shape
Grade II — the breast is a little firm, but appears normal
Grade III — the breast is firm and appears abnormal
Grade IV — the breast is hard, painful to the touch, and appears abnormal


Asymmetry is sometimes indicative of capsular contracture, but if your breasts are soft, it is simply post-surgical asymmetry.  Asymmetry is treated with an internal capsulorrhaphy or placement of an accellular dermal matrix.  This essential involves surgical repair of the pocket to achieve better symmetry.  Capsular contracture rarely resolves with vigorous massage in addition to a medicine called accolate.  Usually it is remedied by open caspulectomy or capsulotomy.  This involves either scoring or removing the capsule from around the implant.  Unfortunately, capsular contracture is a clinical diagnosis and requires an exam.  Follow up with your plastic surgeon first to determine treatment options.  Good luck!!

Jason Hess, MD
San Diego Plastic Surgeon

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