I had 700 cc memory gel implants put in 4 months ago along with a tummy tuck and lipo on my arms, thighs, stomach , lower back and butt. Everything healed fine, but now I have developed capsular contraction in my right breast. II am getting it replaced on July 10 , and since I am already going in for surgery I was thinking about going down a couple of sizes. I am concerned that since I already got cc once, what if it keeps happening, and how will my skin bounce back?
Concerns About Downsizing and Reoccuring Capsular Contracture?
Doctor Answers 4
There is always a risk that if you had a capsular contracture that it may occur again. Some surgeons will opt to use Strattice with the thought that the capsular contracture rate is low with the product, but it is quite expensive.
Preventing Capsular Contracture Recurrence
There is a higher rate of contracture after you've had one. Since we believe that there is a subclinical (in other words, not a symptomatic) infection, or at least a colonization of the capsule that causes the tightening to occur, I remove the capsule and put in a new implant. This minimizes the likelihood of recurrence. I find that the harmonic scalpel, which uses ultrasonic energy to cut, to be particularly useful in this surgery, as it allows for the least amount of disturbance of the surrounding normal tissues.
Going smaller at the same time is a good idea, but shouldn't have any effect on recurrence.
Recurrent caosular contracture
Once a patient has had a capsular contracture ,there is a high rate of recurrence if the implants are simply replaced.
Today we are more familiar with the causes of capsular contracture and how to reduce the risk of recurrence
The following are some of the factors that need to be considered
Implant type ,Gel ,Saline or Adjustable saline with the option if temporary overexpansion of the capsule following release
Capsulectomy v/s capsulotomy .Placement of acellular dermis or absorbable mesh
Implant placement Sub glandular,submuscular or subfascial
Strict aseptic technique ,avoidance of powered gloves
Use of and placement of drains
Antibiotic ,antiseptic irrigation
Post operative antibiotics, ultrasound,Massage avoidance of smoking and medications that cause bleeding
There is conflicting evidence that textured implants have a lower incidence of capsular contracture
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I believe that CC are a result of a low grade infection. In that case you need to have the capsule removed totally if possible. Releasing the capsule has a very high rate of recurrence. Downsizing the implant should have little to do with the risk of recurrence but if you are too big then now is the time to change the implants out as it will save your money and time.
The risk of getting another CC is in the neighborhood of 4% if your remove the entire scar capsule.
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