I am now 7 weeks post op, capsulorraphy on the left breast and capsulectomy on my right breast? (Photos)
Doctor Answers 5
Post Op Concerns
Thank you for your question and photos. You will need to discuss the specifics of your case and treatment with your Plastic Surgeon as they know your situation the best.
Sorry that you are having a problem with your surgery. Based on your pictures you appear to have some degree of contracture. In your most recent picture your right implant sits higher than the left implant. Unfortunately you most likely will need a surgery to lower the implant. Goid luck.
Recurrent capsular contracture
This is the most frustrating problem in aesthetic breast surgery. You might get some benefit from oral medications and aggressive massage but most likely it will require surgery.
The opinions on the treatment of capsular contracture has gone through a lot of changes over the years and many of the prior recommendations that were touted as "state of the art" turned out to be wrong in the long run. Also the use of acellular dermal matrix has been met with mixed results and in addition is extremely expensive for the patients.
We have found that at a minimum implant exchange with complete removal of all scar capsule is necessary and then , if possible, change to a new pocket . If your implant was sub muscular ( as it appears yours is) and the new pocket is now going to be subfascial then it would be a good idea to consider converting both sides to subfascial with a textured anatomic gel implant for symmetry. However, it may not be something you want to consider redoing both sides. So , for unilateral correction in patients such as you, we have found that treatment with total capsulectomy, implant exchange, and then coverage of the new implant ( smooth surface) with a micro thin wrapper of gortex around the implant as opposed to an acellular dermal matrix to be very effective in most cases. In our hands the ADM has not been as effective as the gortex and is much more expensive (2,000 dollars versus 300 dollars).
Ask your surgeon what has worked for him.
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I am now 7 weeks post-breast revision surgery.
Thank you for sharing your question and photographs. I am sorry to hear of your capsular contracture and implant malposition issues. Unfortunately without an in-person examination it is difficult to offer definite advice as your right side does show concern for a recurrent encapsulation. Treatment typically requires capsulectomy, use of new implants, conversion from a subglandular to submuscular position, and use of an internal tissue scaffold. Hope this helps.
Breast implant encapsulation concerns...
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).
Personally, I think that if the breast is "painful and hard", the use of anti-inflammatories such as singular will likely not be effective.
I hope this, and attach link ( demonstrating a case utilizing acellular dermal matrix) helps.
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