Firmness after 2 months- Is this capsular contracture?

Question

It has been 2 months since BA (saline under muscle; 250cc R/180cc L. Both have never felt very soft since day one; in fact now they are quite hard and I find that massaging helps them become softer. However, it seems like it gets firm only a few hours after massaging, therefore I feel a need to masaage them often when I can. My PS in a recent visit mentioned that I may be developing CC. I am hoping it is not CC and that I have tight muscles. If this is the case, when do they typically relax?

Peter E. Johnson, MD · Answer

Firmness that will soften after massage is likely capsular contracture if it has developed slowly after two months. Your breast typically should relax after two to three months. If you can soften the implants with massage there is hope that you can keep them that way if you keep up the effort.

	Best of luck, peterejohnsonmd

Robert L. Kraft, MD, FACS · Answer

Firmness could reflect an early capsule but, equally, could reflect other problems including muscle tightness  The only way to know for sure is to see your plastic surgeon in followup.

Tom J. Pousti, MD · Answer

Thank you for your question.

	It is difficult to say what is going on without an examination.  I would agree that possibly you are experiencing a tight pectoralis muscle (since things seem to soften with massage), but I would recommend that you keep in close communication with your surgeon since he/she knows you best.

	I wish you the best.

Michael A. Jazayeri, MD · Answer

It takes approximately 3 months for the capsule to completely form, so I do not believe this is capsular contracture.  You could have muscle spasm, or plain edema which gets redistributed after massage.  In my opinion, continue your massage and wait 4 more months for all the swelling to resolve and the scar tissue to stabilize.  However, if the problem is worsening with time, please see your surgeon ASAP.

	Please also visit my blog ( which is posted on my web-site home page) and read the blog on capsular contracture.

Barry L. Eppley, MD, DMD · Answer

It is highly unlikely that you would be developing capsular contracture two months out from surgery on both breasts, particularly in saline implants that are placed in the submuscular position.The observation that they soften after massage also indicates that this is not a true capsular contracture...yet. I would continue with the massaging and sleep on your stomach at night if you can. If this is just muscle and skin tightness it will eventually get better. If it is capsular contracture it will get worse with time.

Darryl J. Blinski, MD · Answer

You have posted a informative viewpoint but without an in person examination "I" could not render an accurate diagnosis. I think it could be a CC but at 2 months the muscle still might be tight. Best to obtain in person second opinions.

Mahmood Kara, MD - Account Suspended · Answer

Hello. Thank you for your inquiry and congratulations on your surgery! It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.

Please ensure to get cleared by your doctor before engaging in specific physical activity before the 3 month healing period has ended as the healing stage is crucial for healthy results.

It generally takes around 6 months to a year to see your final results. Your tissues will take time to relax and allow your implants to "Drop and Fluff" settling into place. Should a revision cross your mind, it is best to wait at least 6 months to a year before doing so.

Our tips for recovery following breast augmentation are to wear a supportive sports bra for 3 months post-operative and refrain from lifting anything heavier than 10 lbs for 3 weeks as we don't want any strain at your incision sites. Make sure to keep the area of your stitches clean by cleansing with hydrogen peroxide daily. Showering is encouraged! But, no sitting in water for 2 weeks following surgery (no baths, hot tubs, pools etc.).

Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery. We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

Richard P. Rand, MD, FACS (retired) · Answer

What you are describing does sound more like muscle spasm to me that CC because CC wouldn't relax with massage then tighten up again. You might try more massage and maybe even some muscle relaxants if your doctor approves.

Firmness after 2 months- Is this capsular contracture?

Answers (8)

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