How Long to Wait Before Fixing Capsular Contracture?

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.