I am 4 1/2 months post op from my breast augmentation surgery. I noticed from the first few days that my left breast sat higher than the right. They both have dropped a lot, but the left still sits about an inch higher than the right. I am still taking my medication, wearing my strap, and massaging daily. My PS says it is capsular contracture. Is it possible that the capsular contracture occurred immediately? It always looked higher than the other.
How Early Can Capsular Contracture Start? (photo)
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Doctor Answers 22
Capsular Contracture: Timeline
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.
One of the signs of capsular contracture is malposition of the implant. Additionally, the breast will feel more firm. Although contractures can begin at any time, my experience is that asymmetries that are present immediately after surgery are usually due to a problem with the pocket dimensions. A physical exam is obviously helpful as is allowing some time to elapse to see if the problem worsens. Your plastic surgeon would be best equipped to make this diagnosis so make sure to follow-up as directed.
Asymmetric breasts after augmentation are not always due to contractures
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.
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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,
Vincent Marin, MD
San Diego Plastic Surgeon
The photos show that your left implant is high and yes it has the appearance of a capsular contracture. The literature shows that 98% of capsular contractures will occur within the first 6 months post operatively. I would wait until 6 months post op and perform a capsulectomy while repositioning the implant.
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Contracture can happen as early as the first month. I would bet that if you look at your pre-operative photos your left breast fold sits higher than your right. I could have predicted you would have an implant that sits higher given this anatomical fact. The left fold needs to be lowered most likely to sit in a better position relative the the nipple on the breast mound. I would have to examine you for contracture, but the most important thing is that you know it can be fixed, and you can have the result you desire.
Capsular Contracture After Surgery
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.
How soon do capsular contractures form ?
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.
Glenn Vallecillos, MD, FACS
How Early Can Capsular Contracture Start?
Thanks for posting the photos. Sure CC can occur early but you might consider poor left pocket dissection or inferior release as another option. Or maybe to combination of both.
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.