Steroid Injection for Capsule Prevention?

I recently underwent a Breast Revision surgery, because of a capsule in one breast. I had drains and Medrol Pak after. I am doing exercises, but feel one breast (while mobile) is still stiffer than the other.The doctor told me to come in if the breast began to harden at all and he would administer a steroid injection! I've read uncountable stories online with steroid injection leading to stubborn weight gain and horrible side effects !:( Is steroid injections safe or reasonable for capsules?

Doctor Answers 7

Steroid injections to prevent capsular contracture

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There is no current evidence that steroids will have any effect on prevention of a capsular contracture.  

Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Steroid Injection for Capsule Prevention?

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Those who feel there is a benefit of steroids for CC would be a minority of plastic surgeons. I am not even sure how your surgeon would administer such an injection safely and in such a way that it would reach the capsule. I would work on other non-operative modalities, such as massage, Vitamin E, and  Singulair.  

If you do come to surgery again, consider using Strattice for the pocket revision. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Steroid injection for capsular contracture is not indicated.

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Intra-capsular steroids at the time of breast implant placement was shown at one time to be beneficial but required dose the generated unwanted side effects like extrusion of the prosthesis. There's no indication for use of steroids to prevent capsular contracture at the present time.

Steroid injection for capsular contracture ?

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There have been no demonstrable advantage to using steroids with capsular contracture. In fact for a period of time steroids were used by some plastic surgeons to prevent capsular contracture at the initial augmentation,  creating some disastrous results .On patients who do require release of the contracture or at its earliest appearance, the use of accolate has had some benefit.  I  am unsure where your surgeon would place the steroids, since placing a needle into the pocket is dangerous for the prostheses .

Steroids and capsular contracture

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As far as I know, steroids do not prevent a capsular contracture from forming.  Best to discuss the firmness with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Recurrent Capsular Contractures

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Capsular contractures are certainly the most frustrating problem in breast augmentations for both the patients and the surgeons.  Steroid use fell out of favor years ago because they were shown not to reduce the incidence or recurrence of CC.  I do not know where your surgeon proposes injecting the steroids, but I would be worried about placing a needle blindly into the pocket around an implant for fear of rupturing the implant.  Steroids within the pocket can lead to thinning of the tissues in the lower breast.  Even short term oral steroids have side effects.  Other things like Singulair, ultrasound, massage and pressure (a strap) in combination have been shown to have some effectiveness over time.  Nothing is 100% effective.  Talk to your surgeon about these options.  

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 29 reviews

Steroid Injection for Breast Capsule Prevention?

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Recurrence of capsular contracture around a breast implant is a challenging problem. 

Steroids have not been shown to decrease capsule formation. A Medrol pack is low risk but long term use can cause problems.

If your surgeon thinks the contracture is returning, ask about ultrasound treatment, singular pills, Vitamin E pills, and aggressive massage. Each of these has some limited scientific evidence for stopping the contracture but none is guaranteed to work. 

Good luck.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

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