Chances of Encapsulating After Second Breast Augmentation?

I had Breast Implants put in in 1997. I got pregnant a little while after getting the implants. My implants encapsulated causing pain and discomfort. I had them removed, but chose not to do any reconstructive surgery until I was done having children.

I would like to get a Breast Lift to fix the sagging. However, I am an A cup. My question is if I tried implants again, maybe over the muscle as opposed to under, are my chances extremely high of it encapsulating again?

Doctor Answers 6

Repeat capsular contracture of breast implants

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With the history you are giving, and going to a above the muscle location for the new implant I would say that you have at least a 50% chance of recurrence of the capsular contracture.

Implant encapsulation ofter second augmentation

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I would recommend textured silicone gel implants in combination with your breast lift.

Many surgeons feel that the risk of encapsulation is lower when these implants are used.

I have placed many hundreds of textured implants over the years and have found capsular contracture to be very infrequent.

Risk of repeat (recurrent) capsular contracture with breast implant augmentation surgery

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Going under the muscle has been reported to be associated with a lower rate of capsular contracture. I would try implants. If not, you could consider breast augmentation with your own fat if considering only a modest size increase and have sufficient fat elsewhere.

Capsular contracture after breast implants.

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I would recommend that you go ahead and have a good breast lift together with moderate sized implants.  Of course there are no guarantees, but we see quite a few women like you in New York, and encapsulation does not usually happen again.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon


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First, it is very unusual for capsular contracture to cause pain. In my practice, it is an aesthetic problem, not a health issue.

There is no significant difference in capsular contracture with implants above or below the muscle. However, in my patients who have surgery for contracture, often times we will move the implant to a different location (above or below) just to change the biologic variables hoping to decrease the incidence of contracture.

Having previous contracture probably increases your risk relative to the general population for another but I do not know exact percentages.

Your case needs evaluation from your surgeon

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The reasons patients develop severe contracture vary. If the problem relates to infection or bleeding or something technical, it may be more avoidable. Encapsulation is usually less with "under the muscle" than "over the muscle" implants. Saline implants may also encapsulate to a lesser degree than silicone implants. Larger implants may encapsulate more than smaller implants. These are all tendencies.

Your case needs to be reviewed by your current surgeon to come up with a plan to make repeat encapsulation less likely, but there is always a chance.

John P. Di Saia, MD
Orange Plastic Surgeon

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.