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

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?

Doctor Answers 10

Recurrent encapsulation

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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.

Recurrent capsular contracture

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Thank you so much for your question about your breast augmentation.

I am sorry you are going through this.
A common approach to your distressing problem of recurrent capsular contracture around implants over the muscle would be:
  • new implants, possibly highly cohesive gel and textured,
  • Smaller implants, 
  • Under the muscle
  • Supported with ADM, e.g. Strattice.
Discuss these options with your surgeon. And perhaps a second opinion, before you do anything.

Be sure to see a Board Certified Plastic Surgeon.
Here’s hoping you find this helpful. Have a great day!

Unilateral capsular contracture

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Not so simple. While it is generally accepted that a site change is recommended, and many of us have found adding an acellular dermal matrix such as Strattice very rewarding, the right side will behave differently over time and may drop at a different rate. I would let your surgeon do the research and perhaps send you to a trusted colleague whose opinion he or she values. This is not an emergency.  Take your time and consider all of the alternatives carefully

R. Laurence Berkowitz, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 13 reviews

Capsular contracture after breast augmentation

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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.

Treatment of recurrent capsular contraction after breast augmentation

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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!

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

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Without detailed IN PERSON examination there is no way over the internet a surgical plan can be determined!!!!!

You have few options

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The safest and more predictable procedure would be implant removal ,wait few months for tissue to heal and then use smaller implants under the muscle. This is hard for most patient to accept but the results would more predictable. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Going under the muscle is certainly a great option

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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.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 519 reviews

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

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Thank you for your question.  I am sorry to hear of your experience.  I certainly agree that smaller breast implants in the 350 cc range or lower moved to and under the muscle position should significantly improve your chances for not having a recurrent capsular contracture.  The other option that can be helpful is to wrap the implant inacellular dermal matrix.  Please discuss these options with your surgeon.

Contracture is frustrating

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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!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.8 out of 5 stars 92 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.