Implants from 2021, right breast looks square. Is this likely capsular contraction? (Photos)

Question

Had implants back in 2021 my right breast has changes hape looks square from the side and there is an indent forming above my areola i have an appointment at the breast clinic ais i have a family history of breast cancer and im so worried but im hoping its just implant related. I cant feel whete my implants are at all so hard to tell if it has moved or rotated it does appear quite swollen at the top.

Leila Kasrai, MD, FRCSC · Answer

Unusual changes in shape and sensation should always be examined by your surgeon as soon as possible. This may be related to capsular contracture however please see your surgeon to confirm.

Semih Yildiz, MD, FEBOPRAS · Answer

The photos show the right breast sitting higher with increased upper-pole fullness, a squarer contour, and an indentation above the areola. Those changes can be seen with capsular contracture, particularly if the breast also feels firmer, tighter, or painful, but photographs cannot confirm the diagnosis. Implant malposition, rotation of an anatomical implant, rupture, fluid around the implant, muscle-related distortion, or changes in the breast tissue are other possibilities. Your breast-clinic appointment is the correct next step, especially because the change is unilateral and you report swelling. Examination can assess firmness and implant position; ultrasound is often useful, with mammography or MRI added when appropriate for breast tissue or implant integrity. Tell the clinic the implant brand, surface, shape, and operative details if available. New swelling years after augmentation should be evaluated rather than assumed to be routine contracture, although serious implant-related conditions remain uncommon. Seek more urgent care for rapid enlargement, marked pain, redness, warmth, fever, or a new lump. Avoid forceful massage or attempts to reposition the implant until you have been examined.

Mert Demirel, MD · Answer

First, let me reassure you on one important point: you are already doing the right thing. With a family history of breast cancer and a visible change in the breast, attending the breast clinic appointment is the correct first step &mdash; not because the changes you describe are alarming, but because imaging will properly examine the breast tissue and give you peace of mind before anything else is discussed. Please keep that appointment.That said, the picture you describe is genuinely typical of an implant-related change rather than anything else. When scar tissue around an implant tightens &mdash; what we call capsular contracture &mdash; the implant can be squeezed upward and change shape, which explains the square look from the side, the fullness at the top, and the indent forming above the areola. It can also happen if an implant has shifted or rotated, or if there is a change in the implant itself. The fact that you cannot feel your implants clearly is common and does not mean something is wrong on its own; after five years, these assessments really need an examination by hand and, when needed, an ultrasound or MRI to check the implant's condition. The encouraging news is that all of these implant-related issues are well understood and correctable &mdash; usually with a revision that releases or removes the tightened capsule and replaces or repositions the implant.The most suitable next step would be an in-person consultation with a board-certified plastic surgeon experienced in post–weight loss body contouring. During a physical examination, your skin quality, the areas of looseness on your abdomen and beneath your breasts, and your breast shape can all be properly assessed, and a clear plan can be mapped out &mdash; what to combine, what to stage, and what result you can realistically expect at your current, healthy weight.

Kayla Humenansky, DO · Answer

Given your history of breast implants and the change in shape, swelling, and indentation you’re describing, I would recommend an in-person evaluation with a board-certified plastic surgeon. They can examine the breast and assess for possible capsular contracture, implant malposition, or other causes. Depending on the type of implant you have and your exam findings, imaging such as an ultrasound or MRI may also be recommended to evaluate the integrity and position of the implant. I would encourage you to schedule an appointment with a board-certified plastic surgeon, especially given your personal and family history of breast cancer, to ensure you receive a thorough evaluation.

Serdar Bora Bayraktaroglu, MD · Answer

Your upcoming breast clinic appointment is the exact right step. Given your family history and these physical changes, the specialists will perform an exam and specialized imaging to evaluate your implants. Changes like a squared-off shape, upper swelling, and indentations are very frequently mechanical implant issues&mdash;such as capsular contracture or pocket shifting&mdash;rather than anything else. Imaging will rule out other concerns and check implant integrity. Once completed, you will have a clear, definitive answer and a plan for any needed revision.

Ellen Ozolins, MD · Answer

Thank you for your question. This could be related to capsular contracture, implant malposition, or, less commonly, implant rupture, but it is not possible to diagnose from symptoms alone. Given your family history of breast cancer and the new change in breast shape, it is very appropriate to have an appointment at the breast clinic. They can examine you and, if needed, arrange imaging such as an ultrasound or MRI to determine whether the changes are implant-related or due to another breast condition.

Daniel Barrett, MD · Answer

Dear Kind310920,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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

Ira H. Rex III, MD · Answer

It seems from your description and photograph that you may have capsular contracture.  I think you are doing exactly the right thing by going to the breast clinic for evaluation.  The plastic surgeon would be your next stop.  This is probably implant-based can be fixed in a straightforward manner.  Good luck with things.

John LoMonaco, MD, FACS · Answer

Thanks for photos, but it's hard to tell.  Its possible the impalnt is being help a bit higher on your right by capsular contracture.

I'd need an exam to compare it to the other side and also to check the firmness and movement of the implant.  See a board-certified palstic surgeon for the best advice ! Cheers from Texas !

Zoran Potparic, MD · Answer

Based on these photos photos it looks like you have secondary breast deformity frequently related to breast capsular contracture. However, considering your family history you should first exclude possibility of breast cancer. I hope this helps.

Implants from 2021, right breast looks square. Is this likely capsular contraction? (Photos)

Answers (15)

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