Breast implant is fuller near cleavage, plus it’s firmer and I can feel ripples - is this capsular contracture? (photos)

Question

Hi, a while back I had an augmented mastopexy with 240cc siltex memory gel implants. I developed a seroma on one breast which resulted in implant extrusion, then having to hsve the implant removed. I have surgery booked to have the new implant in the empty breast replaced, however… I have issue with my good breast! It’s firmer and fuller on the side by my cleavage and I can see / feel ripples. Is this capsular contracture?

Leila Kasrai, MD, FRCSC · Answer

Please see your surgeon for an in-person assessment. They can let you know if you do in fact have capsular contracture. It is difficult to say based on your photos alone.

Daniel Barrett, MD · Answer

Dear ricey_79,I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You can still have ripples with gel implants, especially if they are not placed behind the muscle. Your surgeon may be able to transfer fat to help this.

Antonios Mitsakos, MD · Answer

"a while back" is vague and although capsular contracture does not have a strict association with time, knowing the time frame helps. I would recommend a scan (musculoskeletal US or even an MRI) to understand the underlying cause

Derek Fletcher, MD · Answer

Thank you for your question. The hallmark of capsular contracture is implant firmness. Implant rippling can be present early in the progression of cap con. But, over time, the rippling usually disappears as the capsule thickens. You should discuss your concerns with your surgeon. If your implant is visible, fat grafting can help reduce rippling.

Douglas Taranow, DO, FACOS · Answer

A capsular contracture causes the ENTIRE breast to become firmer, and if very contracted, much more round.
Firmness in only one are without shape change is rarely a capsular contracture.  Rippling is a common issue with all implants (saline more so than silicone) and usually seen or felt in areas of the breast with less breast or fat coverage (medial cleavage area, and lateral breasts).
Let your surgeon know of these issues so they may suggest possible remedies while you are there having the other side repaired.
Best wishes,
Dr. Taranow

Camille Cash, MD · Answer

Symptoms of capsular contracture can include firmness of the breast and shifting of the position.  Your surgeon can help determine if it is indeed capsular contracture and what the best option is to treat it.  I've included a video on this that I hope you find helpful.

Breast implant is fuller near cleavage, plus it’s firmer and I can feel ripples - is this capsular contracture? (photos)

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