16 Weeks post Breast Implants. My right breast different from the left, do I have Capsular Contracture? (photo)

Question

Have I got capsular constructure? No pain.. Slightly firmer than the right . does this mean I can never have implants if I have a cc?

Don W. Griffin, MD · Answer

It is possible that you have capsular contracture. You should get reevaluated by your surgeon and develop a plan for treatment. Capsular contracture can be corrected and does not mean that the implant will need to be removed, though it may require replacement with a new implant. Good luck

Vincent N. Zubowicz, MD · Answer

Four months is about as early as capsular contracture is observed. It looks very much like you have a contracture on the right side.

William T. Stoeckel, MD · Answer

It is quite possible that this represents a capsular contracture on the right side. If the right breast appears to be getting more firm and higher on the chest wall with time, then capsular contracture is the likely diagnosis. The other possibility is that the right breast implant pocket was not fully dissected or that you had some notable asymmetry before surgery. If this is the case, then the right breast would not be changing much over time. If you do have a contracture, it can be corrected with another procedure. The chances of having another issue is higher once you have developed a capsular contracture, but it doesn't mean that you can not keep or exchange your implants.

Joseph L. Grzeskiewicz, MD, FACS · Answer

Your image seems to show the appearance of a capsule contracture on the right, and the fact that you note that a your right breast is noticeably firmer to you than your left supports that theory.  However, you will need a formal examination by an experienced board certified plastic surgeon to definitely make that determination.  Sometimes we can manage this with medication, especially in the milder cases, but sometimes it requires surgery to remove the capsule and replace the implant.  It most certainly does not mean that you can never have implants; we just may have to do a little more work to make that succeed!  You should schedule an appointment with your surgeon at the earliest possible opportunity to have an evaluation and formulate a treatment plan.  Best of luck to you.

Robert Whitfield, MD · Answer

You to be seen and examined.  Review of your photos and understanding of your case is best done by the surgeon who performed the case.  If they will not help you then please use the Smart Beauty Guide to find someone in your area and have a lll of your medical records available.

Joseph B. Eby, MD, FACS · Answer

Hello Jdeleon - It would be very unusual to have such an early capsular contracture although theoretically possible, I would consider it somewhat unlikely. Not having looked at your pre-operative photos it is difficult to say if that breaset had an constricted lower pole prior to surgery that was not completely released at the time of the operation. If the breasts looked more symmetric immediately after surgery it may be that you do indeed have an early capsular contracure.  However if the breast was always somewhat high and tight it may be a incomplete release situation. If it appears to be a capsular contracture your surgeon may have you massage the breast and/or start medication that has been shown to help with capsular contracture.

Gaurav Bharti, MD, FACS · Answer

Looking at your photos it certainly appears that the right side is higher and tighter in appearance and likely secondary to capsular contracture.  I would recommend evaluation by your surgeon.  You may require a second procedure to release the contracture and exchange your implant.  Good luck to you.  Gaurav Bharti

Scott L. Replogle, MD (retired) · Answer

I would generally agree with the other responses here that this looks like early capsule contracture although it could still be caused by other issues. The cause of capsule contracture is still understood and there are a number of theories and approaches to it. All implants heal with a capsule around them but for some reason sometimes the capsule acts as if it is inflamed and responds by contracting sort of like a scar contracture. It's not caused by silicone or the implant because it can happen on one side and not the other and can occur long after the implants are in place. The leading theory is that it's caused by low grade (subclinical) infection or some irritant like liquified blood that gets in the capsule or in a biofilm layer on it. Other than trying to prevent any bacteria or blood from staying in the capsule space, treatment has been aimed at cutting inflammation or destroying any subclinical infection. In my experience using an inframammary crease incision to put implants in (avoiding periareolar incisions) I have seen very few capsule contractures of significance but they seem to eventually burn out or become quiescent. At that point the capsule can be opened to release it back to the appropriate size and the implant replaced in case there is residual bacteria on it. Synthetic grafts (ADM's, acellular dermal material) are not needed but if they are used they seem to work by providing a replacement for the capsule that cannot contract. Hopefully in the future we will have a better understanding of what causes capsule contracture and how to avoid it or how to correct it non-surgically.

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

If your breast implant is firmer and has moved up on your chest wall you may have a capsular contraction.  If however your right breast implant has been in a high position since immediately after surgery  your implant pocket may be inadequate or the implant may not have dropped properly.And examination by your plastic surgeon is required to make this diagnosis.If you do have a capsular contraction the capsule can be removed and you can have another breast implant.  However the addition of acellular dermis and possibly textured implants might be required to reduce the chance of another capsule.For more information on breast implant revision please read the following link:

16 Weeks post Breast Implants. My right breast different from the left, do I have Capsular Contracture? (photo)

Answers (9)

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