Have you had any successes treating capsular contracture with Vitamin E and accolate?

Capsular contracture is assessed based on several criteria and then classified according to the Baker grading system, which is the following:Grade 1: the breast feels soft.  Grade 2: the capsule around the implant can be felt.  Grade 3: the capsule around the implant is hard to the touch and visible.  Grade 4: the capsule around the implant is hard to the touch, visible and painful.If caught in the early stages (grade 1 and 2) then sometimes accolade or cingulair can help prevent the capsule from progressing, but there is no hard evidence of this from a high quality randomized control trial. Grades 3 and 4 usually require some sort of surgical management and I would not waste your time on half measures if the capsular contracture is that bad already. Without examining you or seeing photos its difficult to give specific advice though so I'd suggest that you trust your surgeon's judgement and hopefully it will be successful for you.

Thank you for your questions. Once cap con starts, treatment can be very difficult and most often leads to a surgical procedure to properly correct. That being said, there can be some improvement with medical treatment like you are describing. I would recommend you try the medical treatment for a period of three months and re-evaluate whether it is effective. There have also been reports of success with ultrasound treatments, the so-called "Aspen After Surgery" technique, but I have no personal experience with this and cannot vouch for it's effectiveness.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

This treatment has been described in our literature by Dr. S Larry Schlesinger (Hawaii), and has been used by many plastic surgeons to reduce the incidence of capsular contracture, and in about half of cases, reduce developing or ongoing CC.One of my nurses who had breast augmentation began to develop CC after a toe infection, and we successfully stopped and reversed the contracture. I have used this treatment for years with similar success in about 50% of cases in my own patients. Still, that's 50% that avoided surgery!I typically use another leukotriene inhibitor (Singulair), as it has fewer potential side effects, but Accolate blocks two leukotriene pathways, and Singulair one, so Accolate may potentially be better, but with a slightly higher potential risk. You and your surgeon should discuss.But sure, it's definitely worth a try. Surgery is the alternative. Best wishes! Dr. Tholen

Hi.  I have used accolate, sometimes teamed with extended-release papaverine, for early capsular contractures.  (Not the ones where it is rock hard and distorted.)  I've had a response rate that is probably around 40%.  Worth a try for a couple of months - but if you are not making progress, you will need surgery.  I don't use accolate long term, though, without monitoring of liver function tests.I don't think the vitamin E adds anything significant.

Dear mommysusan,
capsular contracture affects people approximately one in 20.  No one knows exactly what causes it and what can prevent it completely. It's important for your doctor to use a minimal incision and a Keller funnel as a sleeve to protect the implant from touching anything before goes into the breast pocket.  Singulair has been shown to prevent it 
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I am sorry to hear about the complication you have experienced. Yes, the use of anti-inflammatories can be effective when it comes to treating early encapsulation. I also think that massage or implant displacement exercises can also be effective.  In more severe cases of encapsulation, revisionary breast surgery utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants , and the use of acellular dermal matrix may be necessary. 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). 
Best wishes.

Thank you for your very informed question. 
A large part of my practice is revising breast augmentations with capsular contracture for one reason or another. If the capsular contracture is noticed early, Accolate has had some success in limiting progression (in my professional experiences), but NOT eliminating it. It's effectiveness varies on a case by case basis. If your contracture is mild and you caught it early (Baker Grade 1...if you google "Baker Classification of Capsular Contracture", you will be able to see examples to compare to your contracture), if I were your surgeon and advising you, perhaps give Accolate a try, but with the mindset that there are no guarantees and in the end the result may still not be totally acceptable to you.  There are a multitude of advanced techniques I employ to reduce the risk of recurrent capsular contracture during re-operation, but even then there are no guarantees. Capsular contracture is a very complex and multi-factorial issue. Best wishes in achieving a beautiful result you can be happy seeing every day. 
Warm Regards,
Michael T. Rossi, MD
San Diego, CA

There is some evidence that accolate can improve capsular contracture.  Some plastic surgeons believe in this treatment and some don't.  Personally I have had several patients that have seen good improvement with accolate when early firmness is noted in breast augmentation.  The patients must understand that this is an off label use of the drug and should not be used of there are medical contraindications.