Is it capsular contracture? Could my left implant never have dropped? Hate the difference in the position of my nipples

I've been having a burning kind of pain/sensation on my left breast. My left shoulder , scapula and neck also hurt. Could it be related to my implants? Noticed that there's an obvious assymetry and my nipples are in totally different places . Can it be capsular contracture or is there a possibility that my left implant never dropped? Would you recommend an explantation ? I've had these silicone implants for almost 4 yrs now. My left implant is 421cc and right is 397cc.

Doctor Answers 6

About Capsular Contracture

One of the most common problems is breast capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant. Nicotine users, such as smokers, have up to a 30x increased risk of #capsular contracture.

Saline implants may deflate spontaneously. When the patient has significant #symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is r#ecommended to ensure adequate pocket dimensions.

New implants may then be placed in the same existing position or may undergo a change of #placement frequently from submammary to subpectoral position and, on occasion, the other way around.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Asymmetry of breasts

your breasts appear to be asymmetrical but this could be due to your asymmetry prior to surgery. It appears that your left nipple areolar complex is smaller and positioned more laterally than your right. If your breast feels hard, then you most likely have a capsular contracture. My advice is to return to your plastic surgeon for an examination.

Susan Kaweski, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 5 reviews

Capsular contractures are pretty easy to appreciate

and it eventually will distort your breast shape to a ball like shape.  If your breasts pinch the same when pinching your mound from below, its not a contracture.  But you do have asymmetric nipples that were likely  that way prior to augmentation.  Your pre-op photos will reveal this if it was and if so, this is simply a reflection of what you started with.  Correction would require your lower areola to be raised with a mastopexy... this could be done in the office under local as well.  So how perfect do you wish to have them?  And are you willing to accept the risks, scarring, and costs of having a mastopexy?

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Why are my breasts different after my enlargement?

Your breasts may be different now because of several reasons including contracture but I suspect that you had asymmetry before your surgery with different position of your nipple areola and this was not addressed. Also, if you had a pregnancy and breast fed since then, this would also change. 

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Breast asymmetry

Your right breast nipple is too low and larger than the left; you need a mini lift on the left to reposition your nipple and increase the lower pole length to match your left side. A consultation is necessary to provide you details regarding minor surgery to provide you better symmetry; Highly suggest physical therapy to help with symptoms on the left.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 68 reviews


Thank you for the photo and question but an examination is needed.  So see your surgeon or other expert in the area
Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 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.