I Developed Capsular Contracture in my Left What Will Happen if I Don't Have It Removed?

Thank you for your question.  For capsular contracture there are non operative modalities, (taking singulair, message, Aspen treatment, short course steroids, etc).  We like singulair in our office, along with the other modalities.  One should take it for 90 days straight.  There are also operative modalities, (capsulectomy, capsulotomy, change of pocket, placement of ADM, removal).  If the non operative modalities fail, the breast usually do not get softer with time.  they usually will harden, and become more odd shaped.  Please speak with a Board Certified Plastic Surgeon about all your options.  The ASAPS and ASPS websites are good places to start.  You may be a better candidate for one over the other.
Jeffrey J. Roth, M.D., F.A.C.S.
Board Certified Plastic Surgeon
Las Vegas Plastic Surgery

For your guidance, the scar tissue that forms around the implant is a natural response to a foreign object implanted in the body. The capsule can tighten and squeeze the implant making it firm. This firmness (breast capsule) can range from slight to very hard. The firmest ones can cause varying degrees of discomfort or pain. There are generally two ways to make the breasts soft. Capsulotomy refers to incisions within the scar tissue that release the capsule allowing more room for the implant. Capsulectomy is a more involved operation that removes all or most of the scar tissue creating a “new, fresh pocket” for the breast implant.
Find a board-certified plastic surgeon that has extensive experience with your case and discuss realistic goals and expectations. Best of luck! #RealSelf100

It’s normal for the body to
react to a foreign material such as a breast implant by forming a scar.This scar surrounds the breast implant and is
known as a capsule.Capsule formation
occurs in every patient to some degree following breast augmentation.In most cases, this represents a normal
response to foreign material being placed inside your body.The presence of a significant capsule has no impact on a
patient’s overall health.Unfortunately,
they tend to be progressive and may significantly disrupt day-to-day life.The tightness associated with capsule
formation can cause significant pain and discomfort.In addition, capsule formation may be
associated with aesthetic deformities as well.Capsules can cause implant distortion and malposition.How capsules progress is unpredictable and for this
reason, it’s not unreasonable to monitor the progress of capsules over the
course of time.It’s important to stay
in close contact with your plastic surgeon.Your surgeon can help you with this very difficult problem.If distortion, malposition, or significant
pain ensues, it’s reasonable to proceed with capsulectomy or capsulotomy at
that time.

Hello! Thank you for your question! Physical examination will determine if you have capsular contracture. The look and feel of hardness surrounding your implant is seen and/or felt. At its worst, you experience pain. It may also cause distortion of your breast. What has caused it will be in question. Your surgeon will likely recommend implant massage and may add the medication Singulair. If these fail, surgical correction may be suggested. It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. Irrigating with certain medications may also be if benefit. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc). Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

As long as the contracture is soft, you may want to hold off.  However, if the scarring is bad and you really want it treated, I would recommend getting the capsule removed and a new implant placed.  You'll still have a risk of getting more contracture, so you may want to entertain the idea of getting Alloderm placed inside as well.  Talk to your plastic surgeon about the details of Alloderm and how it can help you.

If you don't address capsular contracture there is no risk to your health. The scar tissue will not go away without surgery, but this is only a cosmetic issue. If you  begin to develop symptoms (pain) you may want to have the scar tissue removed and the breast implant replaced.  The scar tissue could remain stable for many years, however it could also begin to progressively become harder over time in certain cases.

You don't have to do anything until you have pain and there are no health risks.

Best wishes,

Dr.Bruno

You do not have to have surgery on your breast if you have capsular contracture.  If left alone, it will likely stay the same or get more firm, but it is not harmful.  As long as you don't mind the distorted appearance of the breast and tightness, you could leave the implant alone.  Periodic evaluation of the implant with an MRI for rupture if you have silicone implants would be advised and if there is a rupture, having the implant and capsule removed and replaced at that time would be the most conservative approach.

If you are not having pain / discomfort with the scar tissue being present and don't mind the "change in shape" due to the scar tissue, you don't HAVE to surgically remove the scar tissue.  You can try aggressive massage and ask your surgeon about Accolate to see if that would help in your case.  If you become uncomfortable with the look or the pain associated with the scar tissue, then it's time to have surgery.  Your scar tissue may or may not get worse... no one can predict.

Capsulsar contracture is simply an aggressive scar response around an implant. Massage and sometimes ultrasound therapies can help soften the scar. The natural progression tends to harden to a degree then stay at that level. Surgical removal of the capsule often fixes the problem. To increase the likelihood of success, the use of a dermal matrix (ie Strattice) can decrease the incidence following capsulectomy. The cost of a dermal matrix is significant and thus usually used in tertiary or recurrent cases.

Everyone gets a capsule and you are no different.If one breasts gets harder it can affect the shape suchas in your case.You can massage it and just leave it alone.