How can I tell if I have capsular contracture? (photos)

Capsular Contracture is a condition in which the capsule surrounding the implant thickens and contracts, squeezing the implant making it overly firm or hard and often changing the shape and position of the implant. As the capsule contracts it moves the implant further up your chest wall making upper portion of your breast too large and unshapely. It is more far more common in nicotine users (e.g. smoking, vaping or nicotine gum or patches).

It's quite early into your healing. Hence, it's not likely you are experiencing capsular contracture. Your #healing will continue for 2-3 months for the early period. This includes some #swelling, bruising, malposition, color differences and sensation will be abnormal. Scars will also be changing and asymmetry is not uncommon as each breast heal at different rates before reaching the final result.
But, it can be up to one year see your final result. Your doctor may require you to move or massage the implants within the breast pockets during the #postoperative period. (#Textured implants do not require breast massage.) You must have patience as you heal and if there are any causes of concern, ask questions of the doctor or the nursing staff. 

Thank you for your question!

In general, capsular contracture (CC) can occur at any time,
but most cases are documented in under 12 months (i.e., anywhere from 3 months
to 12 months post operation). This is because it takes time for the fibrous
tissue capsule to form around the implant, and then it will have to scar down
(contract).

Nevertheless, CC can start early when there is significant
bleeding or infection or another co-existing problem.

Usually, the breasts will feel firm and tight this early
after breast augmentation, making you feel that it may be capsular contracture.
However, such tightness is just because the breast tissue and skin have not
adopted to the implants yet. With effects of gravity and healing, the breasts
will feel more natural and soft as time goes. Once that happens, the implant
will sit directly behind the breast tissue in a natural 45:55 breast ratio. Your
breasts will achieve final results after 3 to 6 months post-surgery.

It is also not uncommon for breasts to heal and adapt to
implants at different rates.

Now I need you to know that there are 4 grades/levels of
capsular contracture:

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.

If your breasts do not appear abnormal, tight, firm, or
painful, then you are fine and shouldn’t not be concerned, especially because
it has only been 7 weeks.

Now, grades 1 and 2 CC do not require surgery, and can be
fixed with breast massaging and singulair.

Massaging will keep the naturally occurring capsule
stretched hindering it from contracting. However, this should not be done
excessively as you may further aggravate the breast pocket causing
inflammation.

That being said, you can also help prevent a capsular contracture
by having regular follow-ups with your surgeon to make sure your breasts are
healing beautifully.

Good and transparent communication with your surgeon is
important. Discuss your concerns with your surgeon honestly without getting angry,
and share your expectations of care, and let them know that you do not intend
to be a difficult patient but are following-up to get a physical exam as the
left breast feels ‘very different’ than the other one.

Don't be discouraged.Hope this helps.

Thank you. Capsular contracture takes at least 6 months to form so It is unlikely at 7 weeks. It takes about 3 months for the implant to settle completely, that is for swelling to totally resolve and the muscle to relax so you can get one side slightly different to the other during the healing period. Please get your PS to check on you again, All the best.

Hello misssunshine. It would be very rare to have a capsule contracture at 7 weeks and asymmetry at this point is a fairly normal finding that tends to improve over time. Your plastic surgeon should re-examine your breasts next time to diagnose CC. Perhaps, concentrating on more breast massaging and discussing different massage techniques and even adding a muscle relaxant are other topics you can considering talking to your PS office staff while you wait for your next appointment. Best. Dr. ALDO

Thank you for your question and photos.  It is probably too soon to discuss asymmetry - all looks fine so far.  Best to follow-up for an in person examination with your plastic surgeon to discuss your concerns and evaluate.  Best of luck.

Hello,It wouldn't be unusual at this point to have some asymmetric settling still however if you feel one breast is uncomfortable or becoming firmer then it would be best to have a physical exam.All the best

Thank you for your question and photos. You are still very early in the post-operative period. It typically takes 3 - 6 months for the swelling to subside and and implants to settle into proper position. The implants may swell asymmetrically, but usually settle evenly. ICapsular contracture is unlikely at this time. Please discuss your concerns with your board certified plastic surgeon. Also, make sure you follow all of your plastic surgeons post-operative instructions regarding level of physical activity and use of a support bra. Hope this helps and good luck with your recovery.

Thank you for your question! You do want to keep doing your exercises to help with movement of your implants, this too can help if you have a contracture forming. You can tell you have a hard capsule by the feel of your breasts. They should both be soft and both move within your implant pocket. If your left breast is harder than your right breast I would call your surgeon and have them take a look at it. Sometimes it does take one implant a little longer to drop than the other. Try doing twice the amount of exercises on your left breast than you are your right and see if this helps. Good luck!

Thanks for the question and for the photos.A capsular contracture takes much longer than 7 weeks to form.  It appears that the left breast implant is still sitting high.  This is not uncommon when placed under the muscle.  Massaging, sometimes using an ace bandage above the level of teh nipples aids in having the implant fall into the pocket.  IF after 6 months they are still asymmetrical, a revision might be in order.Best of luck.Dr. T