Capsular Contracture or Malposition or What? (photo)

Unfortunately I moved away from my PS and so I am unable to go see him for a physical exam. I did however send him these pics and he "thinks" I have cc on my left side. I'm a bit confused because it does not feel firm or painful at all, they both soft it's just that the left is sitting way higher than the right and they are very asymmetric. I did have a 2cm asymmetry before and my PS said the CC would exaggerate that. I am 4 1/2 months post op and I am really upset. Could it be a malposition?

Doctor Answers 8

Capsular Contracture or Malposition or What?

Either of the two possibilties would be at the top of the list. Without an exam and from the photos alone I would guess capsular contracture, but given your sense that these are soft, I would temper that guess. 

I can understand why you are upset. Options include seeing your original surgeon, or someone in Denver. All the best. 

Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Breast Implant Asymmetry after Revisionary Breast Surgery?

Hard to say exactly why you have the significant breast  asymmetry present but it is clear that the left breast implant is malpositioned nevertheless. Very likely that revisionary breast surgery will be necessary/helpful.  You may find the attached link helpful to you as you learn more about breast implant malposition and revisionary surgery options.

 Best wishes

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Capsular contracture

It can be difficult to tell the difference between cc and meal position without an examination.  From your description, however,  you say the I plants are soft, so you more likely have malposition.  Also, are you under the muscle? It looks like they are above the muscle. If you do have revision done, you should consider having them placed under the muscle.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Malposition after Breast Augmentation

The fact that you're left breast is soft argues against capsular contracture. I think you probably have malposition of the implants rather than capsular contracture.
Your preoperative photos show the left inframammary crease higher than the right, the top of the left breast higher than the right and a lower nipple on the left compared to the right. It is my opinion that these abnormalities were accentuated by breast augmentation.
Improving this will require additional surgery. I would lower the left implant and raise the right implant. This will improve the nipple height asymmetry but you may also need a periareolar nipple lift on the left side to achieve the best symmetry.
I would encourage you to see a surgeon certified by the American Board of Plastic Surgery who is also a member of the American Society for Aesthetic Plastic Surgeons (ASAPS).

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 79 reviews

Asymmetry worse with larger implants

The asymmery is visible with your smaller implants, and the revision to the 700cc implant has magnified the problem. If the implant is soft a breast capsule is an unlikely cause and this might be considered a position problem. You have to carefully ask yourself how much you like the bigger implant. Repositioning might not be a total solution.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Capsular Contraction or Malposition?

Regardless of what you call it, you have implants that are clearly asymmetric and at 4 months postop they will not change very much. Revision is probably indicated to change the pockets and probably choose a different implant type to a more anatomically correct shape as you have very little natural breast tissue to camouflage the implants. Many Plastic Surgeons would also consider a textured implant especially if there is an element of CC causing your assymmetry. I hope this info is helpful. It will be easy to find a capable Plastic Surgeon in your area.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon
5.0 out of 5 stars 7 reviews

Correction of breast implant capsular contracture - Los Angeles

You may be a candidate for an open capsulectomy or capsulotomy with correction of your breast implants. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Artificial looking augmented breasts are almost always the result of capsular contracture.

The breast the picture demonstrates a completely abnormal distribution of volume. This is due to capsular contracture. It is not a health issue but certainly worthy of an attempt to correct the aesthetic problem.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

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.