Capsular contracture? (photos)
Doctor Answers 17
Thank you for your question and photographs.
Remember, you are still in the early post operative period and breast massage is critical. Vitamin E 1000IU taken twice a day is very beneficial to help prevent capsular contractures. If you have any concerns, please consult your plastic surgeon and ask him to perform a physical examination to determine whether or not you have a capsular contracture. On the photograph with both of your arms down, it appears to me that your are healing normally, however, I think it is essential you see your plastic surgeon and address your concerns.
Good luck in your recovery!
James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgeon
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS
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Possible Capsular Contracture, but too early
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.
Capsular contracture and breast augmentation
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.
Breast implant sitting high
- Your implant is sitting high -
- This happens when implants are put under the muscle.
- The muscle has to relax to let the implant settle in place.
- Capsular contractures take time to form - usually six monthsn at least.
- If your implant does not settle, you will need the capsule released to move the implant into place.
- Ask your surgeon if you can go bra-less....without a bra, some implants settle because gravity pulls them down.
Always see a Board Certified Plastic Surgeon. Best wishes - Elizabeth Morgan MD PHD FACS
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.