Scar Tissue/Adhesions After BA? (photo)

I had primary BA (silicone 375cc submuscular) Aug 2011. Had right contracture 2 months out. It didn't resolve and I had revision (bilat 400cc) Aug 2012. I now have flattening on the right underside and hardening at left incision site. ps says its scar tissue adhesions, and massage won't hurt, also that it will self-resolve eventually. I'm told massage can create more adhesions. I don't want more surgery! what do you think, what kind of massage, and are there any medical interventions for this?

Doctor Answers 5

Breast Surgery

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Once you have had revision surgery it becomes harder and harder to make things look symmetric. I would suggest waiting and continuing with massage and hoping for the best

Why Do I Have Post Revision Flattening On One Breast And Hardness At Incision Site On Other Breast, And What Can Be Done?

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The hardness at the incision site on your left breast is directly related to a recent surgery.  This will soften with time.  However, ultrasound (the kind physical therapists use for sore muscles) and DMSO may hasten the softening.

The flattening at the bottom of your right breast, assuming there is no capsular contracture, is more than likely as your plastic surgeon stated scar adhesions.  I feel that massage of this area is of minimal value but ultrasound and the use of Accolate (Zafirlukast) should decrease the amount of scarring.  Wearing an ace wrap at the top of your breasts and no bra should, with time and gravity, get rid of the flatness at the bottom of your right breast.  

Of course, all of the above assumes no recurrence of the capsular contracture that you were treated for. 

Recurrent capsular contracture?

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It would be most helpful to see a pre-surgery photo before commenting. The breasts clearly look different, but the right side appears to have less lower pole tissue, and if it was like that before surgery, going after capsular contracture would not fix what bothers. you.  

Do continue massage. It does help keep the pockets from contracture and keeps the implants soft. Consider adding a pre-op photo to your question. Thanks and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Scar tissue and capsular contracture

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All patients form an internal scar around the implant which we call a capsule. Massage helps to keep this scar soft. You can not hurt your self with too much massage.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Capsule contracture can recurr

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Thank you for the photos.  Capsule contracture is an abnormally tight or thick breast implant capsule formation.  It is often treated by capsule removal and implant replacement but can recurr.  It is hard to know if your current problem is a new issue or a recurrence of your previous capsule contracture.  Massage may help a capsule contracture.  If it does not a second revision may be needed.  Discuss these issues with your plastic surgeon as you may need to form a long term plan.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

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