Capsulotomy for grade II capuslar contracture? Breast lift w/ implants 2-1/2 years ago. 350cc silicone unders. (photo)

I love my breasts but off and on over the last year or so I've been having frequent pain and tightness in the right breast it actually feels like my breast is contracting It's also firmer and sits slightly higher than the left breast My surgeon didn't suggest a revision at first but as the pain progressed he said a revision was an option but no guarantee it would fix the issue or not reoccur. The pain comes and goes & lately seems it has subsided so I'm unsure if i should go thru w/ the surgery.

Doctor Answers 6

Capsulotomy for grade II capuslar contracture? Breast lift w/ implants 2-1/2 years ago. 350cc silicone unders.

Unless the pain is increasing I would NOT recommend a revision. Try external ultrasound or even some PIT injection therapies.

Treatment of mild capsular contracture?

Your situation is challenging with multiple options.  Before surgery I would suggest a course of Singulair to see if this softens your capsule and alleviates symptoms.  If not successful, I would perform a partial capsulectomy preceded by and followed by a course of Singular in hopes that even if it doesn't soften an existing capsule, it may reduce the recurrence of a new capsule.  I personally feel that a partial capsulectomy is less likely to produce a recurrent capsule than a capsulotomy but this is anecdotal and only based on personal experience.Good luck with your decision! Jon A Perlman MD FACS  Certified, American Board of Plastic Surgery  Extreme Makeover Surgeon ABC TV Best of Los Angeles Award 2015, 2016  Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

I have capsular contractures and am wondering what to do

Capsular contractures are the most challenging condition to deal with for a patient.  I guess this is because every patient is very individual as to whether they will form internal scar tissue around an implant.  Many maneuvers can be tried, but it is accurate to say that when you have formed scar tissue once it is more common to have it happen again.  Every highly experienced Plastic Surgeon can discuss this with you in person in a consultation, and the options are both non surgical as well as surgeical.  Your most important decision at the moment is to choose a very experienced board certified Plastic Surgeon, then feel comfortable that your concerns will be well considered and discussed.
Good luck to you..
Frank Rieger M.D.  Tampa Plastic Surgeon

Mild capsular contracture

As you mentioned, this is a tough decision. The capsule is what it is and it's tough to make it better without surgery. But you may be able to keep it from getting worse: stop smoking if you are, consider antibiotics, consider taking singulair - all slightly theoretical but also some evidence to suggest they help keep a capsule from continuing to get thicker and thus contracting. If that fails then you will have to decide if you can live with it or if you need surgery to try and fix it.

Capsulotomy for grade II capuslar contracture? Breast lift w/ implants 2-1/2 years ago. 350cc silicone unders.

I am 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 (especially for cases of recurrent encapsulation).  In your case, if the pain continues and the asymmetry is of concern, then revisionary breast surgery will likely be indicated/helpful. On the other hand, if the symptoms are very mild and asymmetry minimal, the use of anti-inflammatories (Singular) and displacement exercises may be indicated.
   I hope this, and the attached link/video, helps. Best wishes.

Capsular contracture

Only you can decide if you want to go ahead and have surgery to correct this issue. Like your surgeon stated there is no guarantee that it will correct your discomfort.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.