I had a capsular contracture, had it fixed with mesh, and it came back a year later. Should I have them removed at this point?

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation. There are many ways to treat capsular contracture including revisional surgery.  My surgical approach for recurrent capsular contracture usually includes total capsulectomy, use of a textured implant, conversion to a submuscular plane (if subglandular implant), wrapping the implant in alloderm, and having patients take singulair before and after the surgery.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

At this point, you have to decide if it is worth it ( time and money) to try once again to correct the problem or simply take them out.  There are a number of things that can be done in repeated contracture - change implant position, change the implant shell, use some biological material, use drains, etc.  You mentioned mesh - what kind of material is very important since only one type has really been proven to help prevent contracture.  It is very expensive so surgeons often try cheaper substitutes to help defray the costs.  I recommend going for a few consultations with board certified plastic surgeons that do breast revision work and see what is recommended.  You are welcome to come for a consultation and see what will work best for you.  I hope this helps.

if the capsule is not troublesom to you you don't have to remove them. However of they are then options will be further revision, remove implants completely, use other types of implants with less con traction profile. Which option depends on your circumstances and how much breast tissue you have. If they can be removed and not replaced leaving you with an acceptable breast to you could be a  good option.