Concerned about my 3 time capsular contracture. Would it be best to replace or explant?

Had 410s under the muscle in 2007. Right hardened. Switched both to Naturelle. Left hardened and looked fine from frontal view but was definitely harder. Replaced left implant (3rd surgery). Went on accolade and put in a drain. Left is still hard and I am now having intermittent pain and tightness across my nipple area. All surgeries were done under the crease. Want to replace but not sure if I should just pull them out. Wondering if there have been any new developments in this area. Thank you!!!!

Doctor Answers 6

Multiple capsular contracture

Sounds like that you had every thing that could be possibly done to prevent your capsular contracture. My recommendation would be to remove the implants entirely. Please visit this with your plastic surgeon. 

Multiple capsular contracture

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Sounds like that you had every thing that could be possibly done to prevent your capsular contracture. My recommendation would be to remove the implants entirely. Please visit this with your plastic surgeon. 

Recurrent contracture

You are in a tough spot.  All I can say is that any future attempt should include an acellular dermal Mattix. I believe there is evidence to support its inclusion to maximize your chances for a successful outcome.  I strongly suggest you not allow the additional expense of the ADM to interfere with doing the right thing here.  Good luck. 

Recurrent contracture

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You are in a tough spot.  All I can say is that any future attempt should include an acellular dermal Mattix. I believe there is evidence to support its inclusion to maximize your chances for a successful outcome.  I strongly suggest you not allow the additional expense of the ADM to interfere with doing the right thing here.  Good luck. 

Concerned about my 3 time capsular contracture. Would it be best to replace or explant?

I am sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.  In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix.  Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source ( human, porcine, or bovine in origin).  I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps. 

Concerned about my 3 time capsular contracture. Would it be best to replace or explant?

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I am sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.  In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix.  Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source ( human, porcine, or bovine in origin).  I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps. 

Multiple capsules

Thank you for sharing your problem, hopefully we can give you helpful responses.
It is hard to decide whether to remove or replace again. That decision is one that needs to be made with your surgeon, consider your goals and the risks of further problems.
Removing your implants breaks the cycle and may mean a replacement in the future (2 stages) could still be possible if the outcome was not acceptable to you.
If you go down the path of removal and replacement in a single procedure my usual recommendation would be complete capsulectomy, acellular dermal matrix (I see one has been mentioned and there are others, adds additional cost), new implant (rather than reuse the old one) and drain.
Still not straightforward, statistics don't help when you have the problem however this will usually be effective.
Definitely one to discuss with your surgeon.

Mark Magnusson, FRACS (Plast)
Brisbane Plastic Surgeon
5.0 out of 5 stars 4 reviews

Multiple capsules

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for sharing your problem, hopefully we can give you helpful responses.
It is hard to decide whether to remove or replace again. That decision is one that needs to be made with your surgeon, consider your goals and the risks of further problems.
Removing your implants breaks the cycle and may mean a replacement in the future (2 stages) could still be possible if the outcome was not acceptable to you.
If you go down the path of removal and replacement in a single procedure my usual recommendation would be complete capsulectomy, acellular dermal matrix (I see one has been mentioned and there are others, adds additional cost), new implant (rather than reuse the old one) and drain.
Still not straightforward, statistics don't help when you have the problem however this will usually be effective.
Definitely one to discuss with your surgeon.

Mark Magnusson, FRACS (Plast)
Brisbane Plastic Surgeon

Strattice to prevent recurrent capsular contracture

While nothing is 100% where capsular contracture is concerned, the use of Strattice has been very effective when combined with capsulectomy (removal of the scar capsule) and implant replacement. The downside is that it is fairly expensive but probably better for most cases than implant removal.

Strattice to prevent recurrent capsular contracture

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While nothing is 100% where capsular contracture is concerned, the use of Strattice has been very effective when combined with capsulectomy (removal of the scar capsule) and implant replacement. The downside is that it is fairly expensive but probably better for most cases than implant removal.

Concerned about my 3 time capsular contracture. Would it be best to replace or explant?

I'm sorry to hear about your recurrent capsular contractures. Multiple surgeries for the same problem can be frustrating and disappointing. Sometimes, despite everything that is tried (total capsulectomies, implant replacements, and medications) capsular contractures recur. Without knowing all of the details about your situation, it will be difficult to provide you sound advice about your next decision regarding your implants. At this point, it would be best to have a candid discussion with your plastic surgeon. Thank you for sharing your question and concerns. Best wishes.

Concerned about my 3 time capsular contracture. Would it be best to replace or explant?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I'm sorry to hear about your recurrent capsular contractures. Multiple surgeries for the same problem can be frustrating and disappointing. Sometimes, despite everything that is tried (total capsulectomies, implant replacements, and medications) capsular contractures recur. Without knowing all of the details about your situation, it will be difficult to provide you sound advice about your next decision regarding your implants. At this point, it would be best to have a candid discussion with your plastic surgeon. Thank you for sharing your question and concerns. Best wishes.

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.