What type of imaging can detect capsular contracture?
Doctor Answers 4
Imaging is worthless in evaluating contractures
and at this juncture, you can only consider use of leukotriene inhibitors like Accolate or Aspen ultrasound treatments, both which are not proven but have anecdotal reports to suggest they can help. If you choose the Aspen treatments, make sure you have some kind of warranty to help you if it doesn't work at all... like a partial refund or extra complimentary treatments as patients shouldn't be burdened with the costs if it doesn't work at all. BTW, if you have visible breast distortion, you have a Baker III. You should really be informed of all options before having another procedure.
CC is not detected or graded by a diagnostic modality like MRI, only by clinical characteristics. The Baker grading system is crude and can miss some of the multiple nuances of the problem, however it gets to the heart of the matter: who has a firm breast implant, who has a visible asymmetry, and who is having pain. With these three variables, we can address each with the patient and determine whether a revision surgery is warranted. Women having revision surgery and women having a combined augmentation and mastopexy are at higher risk for the development of CC, so it's not unusual that you have this problem. If you decide to have a revision surgery, you need to have one that will reduce the risk of recurrence: a total en bloc capsulectomy through an inframammary incision, with or without an ADM. If the surgeons you've seen/operated on you are not ABPS certified/ASAPS member surgeons expert in revision surgery, you should visit a few that are. Best of luck!
Imaging is not necessary to diagnose capsular contracture. If you have recurrent capsular contracture, you likely will need a new implant, new incision, new pocket (neosubpectoral pocket) and perhaps a textured implant if you don't already have one. An MRI will show if your implant is ruptured, but not the grade of capsular contracture. Baker 2 is a hard implant that looks normal. Baker 3 is a hard implant that looks abnormal or distorted. You should undergo surgery if you are displeased with the appearance of your breasts or if you are experiencing pain.
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Capsular contracture - what imaging can detect it
Thank you for asking about your capsular contracture.
- I am sorry you have had to have two procedures -
- If your implants are not painful and look ok, do not have more surgery.
- An MRI or CT scan can show a thick capsule but there is not need to have one done because surgery is done based on the problems the contracture causes you.
- If you do have further surgery,be sure the implants are covered with ADM or other material to reduce the risk of a new contracture.
Always see a Board Certified Plastic Surgeon. Best wishes - Elizabeth Morgan MD PHD FACS
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