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

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.

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.

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!

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.

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!

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

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

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. 

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.