Capsular contracture, bottoming out or uneven breasts? (Photos)

one month post op. I went in for my check up and my surgeon noticed the right is low. I have noticed this since the day I got out of surgery but didn't say anything because I have seen so many posts about the breasts healing and dropping at a different rate so I didn't think any thing of it. Anyways my doctor says "when did this start happening? I told him that have noticed this from the beginning. He begins to act like it is my fault and starts saying I use my left arm too much. (I'm a righty)

Doctor Answers 9

Uneven breasts one month post op

You are still very early in the post operative course and asymmetry is very common during this period of time. Both breasts will continue to change as the muscles and other tissues relax and loosen. Continue close follow up with your surgeon. The hands on clinical exams provide much more information than photographs alone and your surgeon can guide you through the remaining recovery. With good followup your surgeon will be able to determine the need, if any, for future treatment or intervention 

Sacramento Plastic Surgeon
4.9 out of 5 stars 45 reviews

Capsular Contracture, Bottoming Out, or Uneven Breasts Following Augmentation.

Hi, and thanks for the question and photos. Some of the photos were taken in a mirror, and others directly, so things are reversed in the mirror photos, but from your birthmarks, it looks like the right implant is in fact bottoming out to some degree. If this is noticed early on (within the first week or two) there is a chance the descent of the implant could be stopped by taping to the infra-mammary fold and/or using a push-up, underwire bra for extra support as the scar tissue "capsule" is forming around the implant. Even when noticed early, however, supporting the implant doesn't always work. You are a month out, so the capsule has probably formed in this lower position, but there is still a chance (and I cannot give you a %) that pushing the implant up (best when done lying down) and taping along the infra-mammary fold (usually done with 2 inch wide foam tape that is available in pharmacies or your surgeon's office) may close off the portion of the pocket that has extended below the fold. Again, this may be a "long shot" but it would be reasonable thing to try for the next 4-6 weeks prior to making the decision to surgically repair the fold on that side. Discuss this further with your surgeon.I hope this helps.

Gregory A. Wiener, MD, FACS
Chicago Plastic Surgeon
4.7 out of 5 stars 75 reviews

Implant Settling

At one month it is very common to see differences in implant height still. It will take between 2-6 months for the implants to completely drop and tissues to soften/expand.  It appears that one of your implants may be slightly too low at this point. I recommend that you keep an eye one that crease for changes and follow up with your Plastic Surgeon.
All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Breast Asymmetry

Hello,It is too early to worry or do anything about asymmetry. Photographs won't tell us what, if anything is wrong. Hopefully you should see gradual improvement in the first 3 months. If not, then over the next three months you will need to get into the mindset of revision surgery, whatever that may be. Right now though, there is nothing to do. Massage, bands etc. are not helpful. Just time.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Asymmetric implants

Thank you for asking about your breast implants.
  • You have one breast that is naturally lower -
  • But the implant looks too low especially when your muscles are relaxed.
  • This is not your fault - nor related to your use of your arms.
  • Give yourself time to heal - 3 - 6 months
  • By then it will probably be clear that you need a revision to tighten the implant pocket and move the implant up.
  • It troubles me that your surgeon is blaming you - I hope he accepts that this isn't your fault and will need probably need a revision.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FAC

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Capsular contracture, bottoming out or uneven breasts?

I am sorry to hear about/see the problems you are having after breast augmentation surgery. I think your concerns are appropriate; on of the breast implants does sit low on your chest wall, consistent with breast implant displacement ("bottoming out”, assuming both breasts are soft?).  Also, consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low.  I think it is most likely that you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation.  I hope this, and the attached link (dedicated to corrective surgery for bottoming out concerns), helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Healing after BA

Thanks for your question and photos. It does appear that your implants are not at the same level, which is somewhat noticeable preoperatively as well. At this point you are still quite early in the healing phase as there is still some noticeable swelling. It can sometimes take up to 3 months for the implants to completely settle and swelling to resolve. If after that time there is still some asymmetry, you may need to have a revision surgery. It is highly unlikely that this is caused by a capsular contracture at this early after surgery. Try to be patient and see how things ultimately turn out. Best of luck, Dr. Kludt

Nathan Kludt, MD
Stockton Plastic Surgeon
4.9 out of 5 stars 28 reviews

Capsular contracture, bottoming out or uneven breasts?

It is too early for capsular contracture. Your right is low and I think you will need that corrected. It is best to wait until 3-4 months after surgery to address this.

Michael Hueneke, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 63 reviews

Most likely bottomed out

The anatomy on the side that is lower can be seen in your preoperative photo.  You implants are now sitting lower on your right.  I would wait a few more month and plan on tightening the right lower capsule.Best Wishes,Nana Mizuguchi, MD

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 49 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.