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 4

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.  

Atlanta Plastic Surgeon
5.0 out of 5 stars 38 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. 

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 56 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 45 reviews

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