Do I have capsular contracture? Asymmetry, very high, and hardness. Advice? (photos)

4 months postopp. Got 390 cc round silicone implants. There was no assymetry before. Surgeon said left was swollen (Left is fuller, heavier, fills out a D cup, right is a fitting a b, but 90% of the volume is above the nipple). surgeon now concedes that left is not going to go down in size and he has no idea why one is larger but can fix it with different sized implants and scoring capsule. Got second opinion. 2nd surgeon says I may have capsule contracture as they're not soft, and very high.

Doctor Answers 4

Your surgeons have told you what they think

and are best equipped to make the diagnosis for you and provide you options for achieving your goals of symmetry.  Your difference is appreciated and if much firmer, would suggest a capsule or a pocket that was not equally dissected.  Regardless, you are looking at a revision down the road if it does not somehow improve on its own and it would involved scoring or removing part of the capsule and either reusing or replacing your implant, depending on what the problems are.


Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Asymmetry

It appears that you have a capsule.  That alone can make the breast look smaller as the implant is being squeezed. There are some medications and non surgical treatments with ultrasound that can sometimes benefit an early capsule. In the end, if surgery is needed, make sure your surgeon is  completely comfortable with doing the procedure.  Capsules do happen and managing the patient through to a successful result is possible. Best wishes. 

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 32 reviews

What causes breast capsules to form?

You have a capsule on the left breast which has pushed the implant to a higher position.  If blood tends to pool on the bottom of the breast a scar will form where the blood pools.  Where scars form it will cause a contraction of the tissues in that area.  When that happens, it will displace the implant as the scar forms.  Simply scoring the capsule only temporarily fixes the problem the scar will reform quickly again.  You need to see what the capsule looks like.  When the capsule is caused by a biofilm which is caused by bacterial colonization of the implant pocket a total capsulectomy is recommended. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 84 reviews

Do I have capsular contracture? Asymmetry, very high, and hardness. Advice?

Thank you for your pictures and questions. Without an in-person exam, it can be hard to give you specific advice. These types of situations can be difficult to diagnose and treat and your plastic surgeon is best equipped to understand what happened at the time of surgery and how things have progressed over time. In your pictures, you have your arms up in the air which can accentuate something that is not there at rest. In addition, you mention some asymmetry but we do not have your pre-op photos to compare, so some of the asymmetry may have been present before surgery and continuing postop. 

In the end, I would say that you should continue to wait longer overall. If at 6-12 months, you are still not pleased with the ultimate outcome, then you should discuss possible revision procedures with your surgeon. 

Best of luck!

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.