What implant is the best fix for my capsular contracture?

Good morning,
While that's not a bad plan overall, perhaps a better plan would be to place your implants under the muscle- under the muscle placement reduces your risk of CC by one half.

As others have stated, implants placed in front of the muscle have a higher capsular contracture rate then behind the muscle. However, implants such as 275 cc will not fit totally submuscular and will extrude inferior and lateral. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, smaller implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Hi. I'm sorry you are dealing with this. I don't think that the size of the implant is causing your contracture, but implants that are "over the muscle" have a much greater chance of creating capsular contracture. If you replace your implants into the same place over the muscle, then you will likely have another contracture, no matter what size or style implant you choose. It would probably be best to switch the implants to "under the muscle." Although you can get a contracture there too, it is less likely to occur in that position. Talk to your plastic surgeon about the options since there are advantages and disadvantages to each one, and you need to understand all of the issues before you do another surgery. Hope that helps. Best of luck!

The incidence of capsular contracture is much higher for sub glandular implants. I would suggest a removal and replacement with capsulectomy and transition to a submuscular pocket.

Dear Luminous8667,
capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Capsular contracture can be frustrating to deal with and there are many approaches to trying to prevent it. Saline implants under the muscle rarely encapsulate so you might consider that option. Your surgeon’s recommendation is also a reasonable one

It's not because of the implant type that you have the encapsulation. A certain percentage of implants encapsulate regardless of the type of implant. However, the great majority of implants encapsulate because of bacteria. Breast contain bacteria just like the skin, and this bacteria can cause the encapsulations. For a reduction of this problem, the first thing surgeons do is make the incision in the inframammory crease, and then put the implant behind the muscle so it is not adjacent to the breast itself as much as possible. This is important.

Absolute sterile technique must be adhered to during surgery. New gloves should be used after making the pocket and before touching the implant on each side. An antibiotic solution should be used in the pocket with the implant.

Stay away from the textured implants. They don't reduce the encapsulation risk, and there is an incidence of a certain type of cancer with these.

Massaging should be stated on the 5th day and these should be specific for breast implant surgery.

Absolute dental hygiene must be adhered to to reduce any gingivitis. This bacteria around the gums does become blood-born when brushing teeth. I suggest a SonicCare tooth brush and flossing twice a day--minimal.

Thank you for your question, and good luck.