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 7

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

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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?

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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 34 reviews

I have capsular contractures and am wondering what to do

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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

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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.

Cain R. Linville, MD
Houston Plastic Surgeon
5.0 out of 5 stars 39 reviews

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

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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.

About Breast Implant Capsular Contracture

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One of the most common problems is breast capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant. Nicotine users, such as smokers, have up to a 30x increased risk of #capsular contracture.

Saline implants may deflate spontaneously. When the patient has significant #symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is recommended to ensure adequate pocket dimensions.

New implants may then be placed in the same existing position or may undergo a change of #placement frequently from submammary to subpectoral position and, on occasion, the other way around. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation. It's best to consult with a board-certified plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your breast augmentation. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery.

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

Capsular contracture

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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
4.2 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.