How Soon Should I Start Singulair After Capsulectomy?

Question

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?

Larry S. Nichter, MD, MS, FACS · Answer

Singulair is used as a FDA off label usage to treat Capsular Contracture and in some cases of recurrence of capsular contracture in a preventative fashion. This does not apply to you for the following reason: Although capsular contractures following breast augmentation can occur just about anytime, most women start having symptoms around three months after their breast implant surgery. This is because it takes some time for a capsule to form and then to scar down (contracture). Therefore it is probably too early at 3 weeks to be concerned about this problem. Your signs and symptoms are most likely from muscle spasm although other factors could also cause this. Your plastic surgeon should be able to sort this our in short order.

Amy T. Bandy, DO, FACS · Answer

I agree with Dr. Gottlieb; the only thing I would add to his suggestions is that if you decide against the acellular dermal matrix, you should consider changing the implants to a new pocket.  When I perform this surgery, I send a sample of the capsule to the lab for culture and sensitivity to see if any bacteria grows, and I start my patients on the Singulair or Accolate immediately after surgery, and the Vit E at 2 weeks post op.  I also follow them closely to see if ultrasound treatments will be necessary.

Raj S. Ambay, MD · Answer

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.

Jourdan Gottlieb, MD · Answer

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.

How Soon Should I Start Singulair After Capsulectomy?

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How Soon Should I Start Singulair After Capsulectomy?

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Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.