Fixing Capsular Contracture - Odds of Reoccurance?

I got my first implants about 8 years ago (425's) and then replaced them with 625's filled to 700 a year later to achieve more upper fulless. I have CC in the right breast and could live with it but now it is getting real snoppy like and in my bras and bathing suits it appears high in the cleavage area. I would like to get it fixed and while doing so get a snoopy lift (making nipple smaller) and going down to 550. Do you think that is possible and would work? Do you think I'd get it again?

Doctor Answers 8

Implant revision for capsular contracture

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The solution for capsular contracture can be elusive, with recurrence rates of perhaps 50%. Often individuals can live with quite alot of firmness, though if the implant pushed up and the nipple low over the implant (snoopy) a reduction of the size, and a lift to get the nipple up front and center may be tolerable even if the capsule comes back. Current thinking is an 'allograft' can help, though the material is expensive.

Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Fixing Capsular Contracture

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This can require rather delicate judgement even after an in person consultation. On line is still more difficult, and without photos..........

Please consider attaching some photos showing at least the current situation. 
If the breast is already sagging and volume of the implants will be decreased, you may find that you need more that the kind of lift you are talking about. 

As far as the contracture goes, there are a number of factors to consider in minimizing the chance of recurrence. Sometimes this requires a position change, and sometimes the addition of an ADM (acellular dermal matrix) is best. 

You seem ready for an in person consultation. RealSelf has listings of surgeons in your area. The American Society of Plastic Surgeons (plasticsurgery dot org) also has listings for your area Cross referencing these to the RealSelf listings assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Thank your for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Fixing Capsular Contracture - Odds of Reoccurance

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Capsular contracture may recur regardless of surgeries being performed at this time and may require additional surgeries. There is as much as a 40% chance that additional surgery will be needed following this operation. 

Nicotine users, such as smokers, have up to a 30 times increased #risk of capsular contracture. The #reason capsular contraction happen is unclear. It's possibly caused by microscopic bacteria on the implant, a   collection of blood after surgery or perhaps it is a tendency for some women to form scar tissue. What we do know is that is cases reported have decreased from 25% to  5-10% or less.

One way to attempt the prevention of it is to follow your surgeon's post op instructions as recommended and ask questions of your surgeon when healing concerns arise.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Fixing Capsular Contracture - Odds of Reoccurance?

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Sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.  In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix.  Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin).  I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps. 

Fixing capsular contracture - odds of recurrence?

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Hello! Thank you for your question! Recurrent capsular contracture is a very difficult problem. Assuming you tried conservative measures in the past - implant massage and may add the medication Singulair and Vitamin E. If these fail, surgical correction may be necessary. It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. Irrigating with certain medications may also be if benefit. Some other things that may have been tried include changing the position of your implant, addition of a dermal matrix, or consideration for the the shaped, textured, anatomical gel implants.

Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. At a 3rd recurrence, it may continue to occur despite all of these modalities and consideration for explantation or living with the contracture are options. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Preventing a recurrent capsular contracture

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If you have had 2 previous capsular contractures then the odds of another problem area very high.  You may want to consider the use of an interposition graft using Strattise.  This has been shown clinically to reduce the risk of recurrence.  I would not place too much emphasis on Singular or Vitamin E.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Capsular Contracture Recurrence Rate Is High

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The recurrence rate of capsular contracture when treated operatively is quite high.  Your implants (700cc) are way too large which significantly increases the chance of contracture.  Your best chance for preventing recurrent contracture would be to replace the implants with much smaller implants which are placed in a virginal area.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Capsular contractures

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Correcting capsular contractures usually require at a minimum removing the capsule and changing the implant.  Sometimes strattice is used as well.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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.