Do I need Strattice to correct grade 3 capsular contracture? Is there another procedure besides ultrasound or surgery? (Photo)

BA on 12/17/15, 397cc silicone, unders, mod profile plus. Last mth, I was diagnosed w/ grade 3 capsular contracture and my PS prescribed 3 ultrasound trtmts per wk for 6 wks at $450. He will re examine me & rec more or surgery w/ straticce. My BA cost $6370. Surgery with straticce will cost $15k-$17k. My PS said ultrasound therapy may not work. 1. Do I have capsular contracture or rupture which caused the capsulation? 2. Is $15k-$17k a rsbl price? 3. Is there another way to fix this? TIA

Doctor Answers 5


There is some clinical evidence that special breast ultrasound machines can redcue capsular contracture. In my experience, using a therapeutic ultrasound machine, there hasn't been much effectiveness. In our office, we have had good success using acoustic sound wave therapy called Z – wave. Usually were starting with grade 2 capsules and having very good success with those. For grade 3 capsule, for my patients I would recommend complete capsulectomy with replacement of at least the bottom half of the capsule from the muscle down to the infra-mammary crease with a large piece of Strattice. Unfortunately, this surgery is difficult and time-consuming and the costs of a new implant as well as a large piece of Strattice makes the surgery costly. Best of luck.

Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Do I need Strattice?

Thank you for sharing your question and photograph.  It does appear that your left breast has a significant CC issue and with the current location, style, and size of implants use of an acellular matrix like Strattice will likely be of benefit in reducing the risks of CC recurrence.  Unfortunately revision procedures are expensive due to the increased time needed in the OR as well as the costs of the matrix material.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Do I need Strattice to correct grade 3 capsular contracture? Is there another procedure besides ultrasound or surgery?

I am sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons. In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants , and the use of acellular dermal matrix (especially for recurrent encapsulation). Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin). I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Strattice + capsulectomy + implant exchange is one of the best strategies for CC

Sorry to hear of your predicament.  Getting ready to use Strattice tomorrow for revisional breast augmentation: RT smooth high profile silicone which has "bottomed" out and LT which has Grade III CC.  This case illustrates two of the indications, for which Strattice is useful.  Breaking down the components of breast revision: Strattice, raw material and procedures (capsulectomy and insertion) + implant exchange, the surgical package varies from 412-15K, depending on your geography.  Ultrasound and Leukotriene A-4 inhibitors (Singulair) are not consistently successful.  I would second Dr. Baxter's recommendation to opt for Strattice.  The only other alternative is to explant :(

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Strattice works well for capsular contracture

There is little evidence that ultrasound therapy helps established cases of capsular contracture, so I would save your money for Strattice. It is expensive because the surgery is more involved than augmentation, you will need to replace the implant, and the Strattice is not cheap (but cheaper than another surgery if you try it without.) You can have an ultrasound or MRI to determine if the implant is ruptured, in which case the manufacturer should give you a new one at no cost.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 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.