Fixing capsular contracture - Odds of recurrence?

Question

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?

Jed H. Horowitz, MD, FACS · Answer

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.

Tom J. Pousti, MD · Answer

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.

Lewis Albert Andres, MD · Answer

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!

Jeffrey Zwiren, MD · Answer

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.

Steven Wallach, MD · Answer

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

Fixing capsular contracture - Odds of recurrence?

Answers (8)

Answer: Preventing a recurrent capsular contracture

Answer: Preventing a recurrent capsular contracture

Answer: Capsular contractures

Answer: Capsular contractures

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Fixing capsular contracture - Odds of recurrence?

Answers (8)

Answer: Preventing a recurrent capsular contracture

Answer: Preventing a recurrent capsular contracture

Answer: Capsular contractures

Answer: Capsular contractures

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.