How Early Can Capsular Contracture Start? (photo)

Capsular contracture occurs when scar tissue begins to form around breast implants and tightens the pocket which the implant resides.  Encapsulation can begin very early, I would estimate within 3 to 4 weeks.  The key to treatement in my experience is to vigorously massage the breast implant and to start medication such as Singulair or Accolate.  These medicines can help by reducing the contraction effect and giving some relaxation of the pocket.  In the pictures which are evaluated, it appears the the left implant began early after surgery in a higher position.  Your surgeon may not have dropped the implant enough or the tight tissues of the left lower breast area displaced the implant upwards and it never dropped; capsular contracture than began and prevented the implant from being able to drop and settle.   Surgical correction is likely needed to give better symmetry.   

I'm sorry to hear about the issues that you have been experiencing. In the early stages of capsular contracture, medication may be helpful. I would suggest talking with your surgeon about nonsurgical options to attempt to improve the contracture. If the contracture cannot be improved then surgery may be need to removal the scar tissue and place a new implant. 

It could have happened very early on, but it could also have been an uneven pocket from the beginning.  Capsular contracture is a clinical diagnosis and the pictures dont really show any severe degree of contracture. You could be experiencing uneven breast implant pockets. It's best to follow up with your plastic surgeon.

Your left breast implant sits high - this appears to be a positioning problem, as opposed to capsular contracture, as your inframammary incision appears to be much higher on that side.

I would guess that you will need to have an operation to adjust the position of the left implant.

I recommend you discuss this with your surgeon.

Good luck!

Based on the photos you have sent along - my guess is that this represents implant malposition, unrelated to capsular contracture. The solution is relatively straight forward, but does involve additional surgery. You could 'wait it out' for a few months longer, but its unlikely that you'll see a dramatic change.

Hello,

I'm sorry you are having this problem.  Capsular contracture can happen very early, especially if there was fluid (blood, bloody water, or pure watery fluid) in the pocket after the surgery. Unfortunately, bra straps, implant massage, or medications do not reliably alter the course, and most end up with a final malposition.

Looking at your 4 day post op, you certainly looked full on top, and that may be due to fluid accumulation.  It could also be due to implant malposition, however I'm not terribly impressed with any potential difference in your inframammary folds at that time. Your left fold definitely moved up between 4 days and 4 months, and that is a tell tale sign of contracture. There is a possibly that there was some malposition, but it looks like capsular contracture is also involved.

Best of luck.

It can be very difficult in the first few months after surgery to differentiate between a capsular contracture and an implant malposition. Typically, capsular contractures are a progressive process whereas an implant malposition presents soon after surgery. Ultimately, both processes require revision surgery to release the pocket (or capsule). A capsular contracture may benefit from additional treatments. I encourage you to continue working with your plastic surgeon to guide you through this period.

and your immediate post-op photos suggest your left side was already higher and less full on the bottom then the right.  As surgeons, we always would love to find fault with something else besides our own skill but in my office, my revision policy ignores what may have caused but focuses more on fixing the problem.  I hope your doctor has a favorable revision policy (like a no-fault one) where you clearly understood what you had to do prior to your procedure if you had bad luck as you do right now.  Unless your breasts if firmer than the opposite side, your problem is more one of malposition rather than contracture.  Regardless, if you wish to have 'more perfect' breasts, you will need a revision. Please understand that revisions may produce results that you still find unsatisfactory.  Best wishes in achieving your goals.

Hello and thank you for the question.

 

Capsular contracture, or abnormal thickening of the breast implant capsule, can develop at any point following breast augmentation surgery and most cases do develop early on, meaning well under a years time. Keep in mind that the development of a capsular contracture is a dynamic process which evolves, hence it is difficult to pinpoint a precise time of onset of development.  When capsular contractures do develop, it is advisable to wait at least a year from the date of surgery before considering a surgical correction, as ample time is needed for the scar to mature, which allows for a greater rate of success.

 

Kindest Regards,

 

Glenn Vallecillos, MD, FACS

 

From your photos, it appears that you may have had an insufficient pocket dissected as the left side has always been a bit smaller than the right. It might be possible to make an easy correction by releasing the capsule and allowing that implant to drop further. At 5 months, it is likely that massage and/or strapping wont make much of a difference. 

Best of luck!