Capsular Contraction in Breast Second Time Around?

I got my first breast augmentation 5 years ago with 250 cc gel implants. I soon after got capsular contraction in both breast. After 4 years I changed them out with 300 cc gel implants, they are now hard again. I am having my 3rd and last surgery next week (capsulectomy). How soon after should I start Singular and vitamin E? And how often should I take it?

Doctor Answers 7

Capsular Contraction in Breast Second Time Around?

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.  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 ( human, porcine, or bovine in origin).  I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps. 

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Singular, Biologic mesh and under the muscle to prevent capsular contracture?

The use of Singular to prevent capsular contracture is debatable and unproven, but the risks of taking the medication are more finite. Potentially troubleshooting the reason for capsular contracture is a good start. Your question is very complicated.  Capsular contracture is not always preventable.  It can occur due to an infection, radiation, hematoma or just the way and individual heals.  Capsular contracture can be minimized from the surgeon's side by placing the implant underneath the muscle and/ or using a biologic mesh as a buffer between the skin and implant may help. This may be a prudent way to go given that placing the implant above the muscle is known to have a higher rate of capsular contracture. Some surgeons advocate breast massage as away to keep an implant mobile in a capsular pocket. Its effects on capsular contracture are debatable and unknown. The rate of return depends on the reason the capsular contraction first occurred.  Also, if the capsule was removed, scored or partially removed is also important to know to make a reasonable assessment. Truly because of the complexity, you should consult with a board certified plastic surgeon who is comfortable with complicated revisions of the breast.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.3 out of 5 stars 34 reviews

Preventing a 3rd bilateral capsular contracture

If you have had 2 previous capsular contractures then the odds of another problem area very high.  You may want to consider the use of an interposition graft using Strattise.  This has been shown clinically to reduce the risk of recurrence.  I would not place too much emphasis on Singular or Vitamin E.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Recurrent capsular contracture with breast implants

I'm not certain if it is wise to use singular for capsular contracture prevention.  There is a small risk of very serious side effects which should be discussed with your doctor.  The data regarding its effectiveness with capsular contracture prevention are not clear.  I have had good luck with the use of strattice acellular dermal matirx for preventing very difficult recurrent capsular contractures. 

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Capsular contractures

I am not sure if singulair really works.  Vitamin E has not been shown to help. It is thought that using an acellular dermal matrix may help minimize the risk.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Recurrent capsular contracture

Treatment of capsular contracture and recurrent capsular contracture is somewhat controversial but capsulectomy with possible site change (over to under muscle) and new implant placement is best bet. I prefer to use Strattice in these cases as most studies show a reduction in capsular contracture rate and the Strattice is  excellent for tissue support after capsulectomy

Jason Pozner, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 45 reviews

Capsular Contraction in Breast Second Time Around

Those questions are best addressed to your surgeon. Neither is likely to contribute to any wound healing problems. One thing you may wish to discuss with your surgeon is whether the use of an acellular dermal matrix is a worthwhile consideration. The material is pricey, but the success rate in treating capsular contracture seems higher than by the other common surgical methods.

Thanks and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.