6 weeks post op, have I developed capsular contracture? (photo)

Capsular contracture at 6 weeks after surgery is unlikely. More likely, one side is settling faster then the other. See you plastic surgeon. Get checked, and see if there is anything that can be done to help the high side catch-up.

Six weeks after augmentation there is still swelling present and the implants have not settled. Mild asymmetries at this point are common, and most resolve over time. While you may be developing a contracture, it is more likely the implant asymmetry is due to malpositionat the time of surgery, or fluid accumulation around the implant. I usually recommend vigourous massage and use of a band over the top of the breast to assist the implant settling. If this fails to occur in a reasonable period of time, surgical revision will be necessary. Discuss your concerns with your surgeon and follow their instructions for post op care.

Thank you for this interesting question.  It would have been helpful if you would have sent a pre operative picture of your breasts as the post operative picture you sent could have had multiple causative factors. Some of your RealSelf experts have stated that 6 weeks is too early to get a capsular contracture.  This theory was debunked in a paper written by Dr. Robert A. Ersek, of Austin, Texas discussing the ability of capsular contractures to occur in the first week after breast augmentation.The picture you provided possibly is an early capsular contracture on the right, but when I see your picture, it looks more like a tuberous (constricted) breast with insufficient release below the areola and an apparent short distance from the nipple to the inframammary fold.  At this point, I believe it is appropriate to have an in person exam by your personal plastic surgeon, discuss possible causes of your right breast malpositioning, and also possible treatments.

It is highly unlikely that you have developed capsular contracture this soon after surgery.  You are still going through the healing process.  It is very normal for one breast to settle sooner than the other side.  I find that the implant on the dominant side (right side if you're right handed) will often take a little longer to settle than the non-dominant side.  The muscle on the dominant side is usually stronger and is being used more than the other side after surgery which keeps the implant higher longer.  Be patient and follow-up with your surgeon.

Dear pgalindo,
I understand your concern and it is quite normal to be concerned about the outcome following a breast augmentation surgery. However, you are still in the very early stages of the healing process at 1 days  post op.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues around the implants are still swollen. Once the swelling subsides and the implants drop to their final position, you will be able to see the final result of your breast augmentation surgery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery