I had implants 2 years ago, capsular contraction and implant shift, what are my options?

Question

Left side have capsular contraction again (had a revision 1 year ago).......right side implant has shifted up. Implants under the fascia, smooth round high profile gel - 475 in both. My Dr. said he would redo them....stitch the right side so no shift, and hope for the best on the left side. I am wondering if there are any better options out there......going smaller, under the muscle - is there anything that would make my chances better - instead of redoing the procedure in the same manner?

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and excellent pictures.  Sorry for your struggles. Creating a new pocket under the muscle is your best chance to avoid another encapsulation. Good Luck.

Jerome Edelstein, MD · Answer

Going under the muscle (subpectoral) is certainly a good option.  It will create a fresh new pocket, and it is generally accepted that the risk of capsular contracture is lower under the muscle.  Some feel it is important to remove the lower part of the capsule that still will be in contact with the implant, and to use new implants, preferably smooth.  Recent evidence is showing that textured implants may actually increase the risk of capsular contracture, even though for a very long time we thought the opposite was true.  Hope this was helpful.

James F. Boynton, MD, FACS · Answer

First of all, I agree with my colleagues and you need to go and visit with your plastic surgeon to discuss your options.  Only your plastic surgeon can determine for sure whether you have capsular contraction, or recurrent capsular contraction.  I can only speak from my experience in treating capsular contraction. I devote a large portion of my practice to revision breast augmentation, and I have treated recurrent capsular contraction many times successfully.  It appears from your photos, that there may be a slight malposition, but I cannot tell without examination if you actually have capsular contraction.  If you do have a capsular contraction what I have found to be the most effective treatment for recurrent capsular contraction is removal of the implants, with replacement of new silicone gel implants (maybe slightly smaller size), converting the implants to a true sub muscular pocket, performing a full capsulectomy, and the use of an ADM (acellular dermal matrix) such as Strattice to prevent recurrent capsular contracture.  I have treated many 2nd, 3rd time recurrent contractures and this surgical plan does work. Discuss your options with your plastic surgeon.  I hope this helps!

Martin Jugenburg, MD · Answer

Going under the muscle is certainly a great option when suffering from a capsular contracture and the implant is currently sitting above the muscle.  Going under the muscle has a lower risk of capsular contracture in general and should lower the risk of recurrence.  Other things to consider are implant exchange, use of alloderm, and total removal of the existing capsule.

M. Scott Haydon, MD · Answer

Thanks for your question and your pics. I'm sorry you are having this issue. Statistically, contracture rates are lower with implants less than or equal to 350CC and under the muscle. By decreasing the volume some and placing them beneath the muscle you should have less pressure and hopefully less capsule formation. The only other consideration would be to add an acellular dermal matrix like Strattice. Best of Luck!

I had implants 2 years ago, capsular contraction and implant shift, what are my options?

Answers (9)

Answer: Going under the muscle is certainly a great option

Answer: Going under the muscle is certainly a great option

Answer: Contracture is frustrating

Answer: Contracture is frustrating

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Everything you need to know about Breast Augmentation

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I had implants 2 years ago, capsular contraction and implant shift, what are my options?

Answers (9)

Answer: Going under the muscle is certainly a great option

Answer: Going under the muscle is certainly a great option

Answer: Contracture is frustrating

Answer: Contracture is frustrating

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Recommended reading

Everything you need to know about Breast Augmentation

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