What is the most recommended way to fix capsular contracture?

Hi everyone, here is the background story: I had breast augmentation last year in July. After a couple of months, my surgeon told me I was developing capsular contracture and he recommended me having ultrasound therapy for several weeks. But, at this point I became very upset at his lack of support and sympathy for what I was going through.

Doctor Answers 13

Correcting Capsular Contracture

Capsular Contraction is the #scar tissue that forms around the #implant is a natural response to a foreign object implanted in the body. The capsule can tighten and squeeze the implant making it firm. This is referred to as capsular contracture. This firmness (breast capsule) can range from slight to very hard. The firmest ones can cause varying degrees of discomfort or pain. #CapsularContracture can occur in one breast or both.
Those experiencing this are candidates for Breast Revision Surgery. An implant revision or exchange intends to replace the damaged implants with new silicone or saline filled implants with newer technology. Secondary breast surgery can be complex and needs to be done by an experienced plastic surgeon. The specific procedure to be performed will depend on the complications experienced and the condition of the implants.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Recommended way to fix capsular contracture

This is a condition where the capsule around the implant thickens and squeezes the implant making it hard and often changing the shape and position of the implant. Effective treatment of the capsule frequently involves completely removal of the capsule (capsulectomy), and occasional incisions in the capsule may be somewhat helpful (capsulotomy). At times it is necessary to change the position of the implant, either above or below the muscle, depending upon the initial position, changing the implants themselves and, on occasion, the use of Acellular Dermal Matrix (ADM) may be required to prevent continued problems.
#breastrevision #breastimplants

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Capsular contracture

I think that the first thing that you need to do is define what exactly your problem is, before deciding how to treat it .If you do indeed have a scar capsule that is tight and is distorting your implant and even progressing to the point where it is causing pain, then you will likely require surgery to either release or remove this capsule. If your implant is soft but the breast mound doesn't match the other side, then other issues may be occurring.  Getting a second opinion may help answer some of your questions.

John Dean, MD
Baton Rouge Plastic Surgeon
4.3 out of 5 stars 18 reviews

Capsular Contracture

I appreciate your question.
Removal/replacement of the implants with capsulectomy and possible use of acellular dermal matrix.  I recommend you see another Surgeon for a second opinion since you are unhappy with the support you are currently receiving.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Capsular contracture

Hi, lovelykay.  Sorry that you have capsular contracture.  Unfortunately, only reliable way to remove capsular contracture is through implant exchange and capsulectomy.  There is a possibility for recurrence.  Textured implant and use of dermal matrix may decrease the risk of recurrence.  Please visit a board-certified plastic surgeon to be evaluated.  Best regards.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

What is the most recommended way to fix capsular contracture?

There have been many methods that have been tried for releasing a capsular contracture.  Closed compression, medications, ultrasound, and ASTYM are a few. However, once a capsular contracture forms the only definitive therapy is open capsulectomy/capsulotomy depending upon the findings at the time of surgery.  Even then the capsules can reoccur. Find another board certified  plastic surgeon to see.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
4.7 out of 5 stars 12 reviews

What is the most recommended way to fix capsular contracture?

Hello! Thank you for your question! It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capsule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from ruptured implant vs pain vs simple pocket adjustment, etc). Implants mayor may not be replaced depending on your discussion and reason for capsulectomy.

Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies (in an en bloc fashion) in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Most patients tolerate this procedure very well with minimal downtime. It is typically an outpatient procedure with most being able to resume activities within a few days along with restrictions for a week or so. Many surgeons will recommend a postoperative garment for several weeks postop as well. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Persistent capsular contracture need surgery

Only fix for capsular contracture is surgical release and excision.  However there is a very high recurrence rate even after surgery.    You need to discuss your options with your surgeon.   

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

What is the most recommended way to fix capsular contracture?

Hi.. thank you for the question.. sorry for that... Generally the best way to treat a capsular contracture after 6 months is with surgery... in these procedure a capsulectomy or capsulotomy could be done depending the grade. 

Luis A. Mejia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 74 reviews

Capsular contracture

Massage is the main stay of treatment for smooth implants. Zafilukirst or monolukirst are medications that I have seen success with, they require at least a month to show any effectiveness, in patients with capsular contracture. Also ultrasound treatment is sometimes helpful. If these don't help then ultrasound and MRI analysis may be done to help determine only in silicone implants if there is a rupture. You are not alone. Sometimes surgery is helpful by removing the capsule or a capsulotomy, releasing the bands of the capsule and or changing the size, shape and or texture of the implant. Feel better and good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 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.