Capsule contracture, what does it feel like?

Question

Can someone explain what the feel of the pain of capsule contracture is? I have over the muscle implants only in a week but when I move it feels like the muscle is pulling in one breast ? Is this normal? I'm very worried

Donovan Rosas, MD · Answer

Capsular contracture is a gradual thickening/tightening of the usually normal scar which the body surrounds the implant with naturally.The process takes time to develop and can be seen anywhere between 3-6 months and a year post operatively. It is also typically progressive, beginning with some firmness which progresses to a visible change in appearance (the classic suction cup to the chest appearance) finally becoming painful.Capsules are more common in subglandular augmentation. A relationship to the peri-areolar approach has also been proposed (due to the potential for biofilm contamination). They are also more common in those who have had them before with a fairly high recurrence rate. Textured devices can lower the risk especially in the subglandular population.With regards to your specific question, it is impossible to determine whether or not you have developed a contracture without an in-person exam. However, 1 week is too early as a contracture requires a capsule which in turn takes time to develop. You are likely experiencing normal post operative discomfort.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Martin Jugenburg, MD · Answer

You must be
concerned about this and that is understandable.
In breast augmentation, capsular contracture refers to
tightening of the scar tissue that normally forms around the implants resulting
in hardened, painful, and abnormal looking breasts with varying degrees of
severity. The capsule is fibrous tissue that naturally forms when anything
foreign is placed in our body – this happens with heart devices as well.
However, when there is too much inflammation, fluid collection, or bacterial
contamination, the fibrous capsule can start to scar down further and contract.

In general, capsular contracture (CC) can occur at any time,
but most cases are documented in under 12 months (i.e., anywhere from 3 months
to 12 months post operation). This is because it takes time for the fibrous
tissue capsule to form around the implant, and then it will have to scar down
(contract). 
Please still know that capsular contracture can start early
when there is significant bleeding, hematoma, or infection or another
co-existing problem. 
There are 4 grades/levels of capsular contracture:
Grade I — the breast is normally soft and appears natural in
size and shape
Grade II — the breast is a little firm, but appears normal.
Grade III — the breast is firm and appears abnormal.
Grade IV — the breast is hard, painful to the touch, and
appears abnormal.
The pain varies in description.
You can know about the capsular contracture using these
classifications and applying them to your case. Note that you will always have
to get anything checked with your plastic surgeon for accurate diagnosis as
breasts can appear hard and tight early in the post-operative period. Even
though one side of your breast is more firm, it may just be that the breasts
are adapting to implants at different rates. In fact, it is not uncommon for
breasts to heal and adapt to implants at different rates. 
In case you do have capsular contracture, but your breasts
do not appear abnormal, or painful, then you do not require surgery. This may
be the current case with you, but caution is necessary to prevent worsening of
the symptoms.
Good and transparent communication with your surgeon is
important. Discuss your concerns with your surgeon in an in-person follow-up.
Their instructions should take precedence over everything else you read here.
Hope this helps.

Linda J. Leffel, MD · Answer

One week after breast augmentation, the pain and discomfort you describe is related to your recent breast augmentation surgery.  At your post operative visit, please discuss your concerns with your board certified plastic surgeon.

Vincent P. Marin, MD, FACS · Answer

Capsular contracture after one week is virtually impossible unless you had it prior. This tightness is almost certainly swelling and discomfort from the dissection on top of the muscle. This will subside with time. However, you should continue close follow-up with your doctor to make sure you don't have excessive bleeding, etc. Keep in mind that the risk of CC is higher over the muscle.
You should continue to follow up with your doctor to ensure you progress as planned.

Brooke R. Seckel, MD, FACS (retired) · Answer

Capsular contracture does not happen in the first few weeks after breast augmentation It typically takes 6 months or more.  See her plastic surgeon for an examination to check implant mobility.

Capsule contracture, what does it feel like?

Answers (5)

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