How Long to Wait Before Fixing Capsular Contracture?

Unfortunately, you describe classic capsular
contracture following breast augmentation surgery.Whenever a foreign material is placed inside
your body, it will generate a reaction from the surrounding tissue.This typically results in a fibrous capsule
that surrounds the breast implant.When
this occurs, following breast augmentation we all this a capsular contracture.All
patients have some capsule formation.Indeed absence of capsule formation results in implant shifting.When capsule formation results in
contracture, patients may experience hardening of the breast, distortion of the
breasts and breast pain.Capsule
formation may occur at any time and as time goes on, this may be accompanied by
pain and progressive distortion of the breasts.The breasts may shift in an upward direction and develop an abnormal
shape.The
period of time immediately following breast augmentation surgery is
characterized by rapid change.During
this dynamic phase of wound healing, swelling, muscle spasm, acute inflammation
and the wound healing process itself all contribute to changes in the
appearance of the breast.For this
reason we delay capsulectomy and capsulotomy for at least 3 to 6 months following
stabilization of the situation.When
capsular contracture occurs, there are several treatment options.In mild cases, medical management and massage
may be necessary.This may require
release of the contracture by performing a capsulotomy, or removal of the
capsule by performing a capsulectomy.Treatment is associated with high satisfaction rates.

Typically, it's best to wait 6  to 12 months depending on the reason for #revision.  Matters such as sagging or drooping  and size change will not improve with time. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.

There is no evidence to confirm whether the inflammation will worsen or subside with time. I advise all patients to treat capsular contracture as soon as possible. Raffy Karamanoukian MD FACSLos Angeles

Your capsular contracture has occurred very early after an initial breast augmentation. It may improve over time with some regular massage of the breast. I generally will wait at least 6-12 months after an augmentation before considering any surgery . If I think surgery is indicated I will first try a capsulotomy ( cutting of the capsular tissue) often under a local anesthetic with light oral sedation. This will often correct the problem with a minimally invasive procedure and at a low cost to the patient.I don't think using a dermal matrix product is indicated after an initial augmentation. If may however be very useful in patients that have had recurrent capsular formation, or severally ruptured silicone implants with really bad capsule formation

I would wait 4-6 months after the contracture process has stopped changing before surgically correcting a capsular contracture.
There are several different treatment options for an established capsular contracture.. Many surgeons feel that it is important to create a site change and replace the implant with a new one. A site change refers to moving the implant to a new pocket location. For instance if the implant had been placed underneath the breast tissue the new pocket is made under the muscle layer. If the implant was originally under the muscle it can either be placed under the breast or in what's called a" neo-pectoral pocket". A neo-pectoral pocket is developed by temporarily removing the implant and creating a new pocket behind the back wall of the capsule surrounding the implant. The implant is then placed in this new pocket. Most surgeons agree that it is also important to put in a new implant when treating a capsular contracture. This is due to the possibility that the old implant is covered by "biofilm". Biofilm is thought to be one of the causative agents for a capsular contracture. Biofilm is a barrier that forms around some implants possibly secondary to a subclinical infection. A subclinical infection is one that affects the breast implant pocket but does not cause any other external symptoms. Some surgeons recommend the use of Strattice. Unfortunately Strattice is quite expensive.
One of the simplest ways to release a capsular contracture is by performing a capsulotomy. In the performance of a capsulotomy the previous incision is opened, the implant is removed and the capsule is then cut in several different locations to release the constrictions allowing the pocket to open up and return to its original size. The original implant is replaced with a new one and the wound is closed. In the past, however this procedure has been associated with a relatively high rate of recurrence. Two years ago I received some advice from a well respected plastic surgeon from Grand Rapids Michigan. He told me that he has been treating capsular contractures by performing the capsulotomy and then immediately placing the patient on a ten to fifteen day regimen of prednisone and a six-week regimen of Singulair. Both medications are started on the day of surgery. Over the last two years I have treated several capsular contractures with this regimen. None of the patients have had a recurrence of the capsular contracture and all of the patient's tolerated the medication very well.