Breast augumentation surgery december 2012 under the muscle mentor ultra high Silicone 500cc. Im posting before and after pictures i really need help . I went to my postop and my doctor said i need a revision on my left breast capsular contracture. My breast was uneven before the surgery now its just worse ! Left is sitting high right is low. do i only need a removal of the capsule ? What if the left breast pocket was small ? Top of my breast is empty (left side) its hanging down flat not round
Capsular Contracture ?
Doctor Answers 7
Asymmetry after augmentation
can result from a long list of possibilities. If you have a contracture, that breast should be much firmer to touch/squeezing. And if you do, there are so many questions as to what may have contributed to it or if you are simply one of those who will have contractures regardless of what is done. And if you have a revision, you need to really think about what you like better... the upper pole fullness or the natural look as it may change the plan to achieve those results. If you like the left side better, the right needs to come up. Lifts may be required to even out your nipples if you wish to have that. So talk to your surgeon and hopefully the revision policy is a reasonable one.
Capsular Contracture ?
Determining the difference between an insufficiently dissected inferior aspect of the pocket and high implant vs high implant from capsular contracture is fairly easy with physical exam. Your surgeon is in the best position to give advice. Kenneth Hughes, MD Los Angeles, CA
It is very possible that you have a capsular contracture. A new implant and removal of the capsule can often correct this problem.
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Capsular contracture after silicon breast implants
It does look like you have developed capsular contracture on your left breast. The implant is high riding and the breast gland itself is no longer sitting in the correct place on top of the implant. Your right breast implant looks as though it is no longer under the muscle and is sitting much lower than the left.
I agree that you would benefit from revision surgery. Removing all the capsule is difficult, especially with submuscular implants. I would suggest at least a partial capsulectomy and replacement of a new implant in a new pocket under the breast (subglandular or subfascial), rather than under the muscle.
I think you will still have some asymmetry following revision surgery but I would expect a significant improvement.
There is some risk of developing recurrent capsular contracture but hopefully if appropriate precautions are undertaken this will not happen. The main way to reduce risk is by minimising chance of infection or contamination of the new implant during insertion.
Good luck with your surgery.
Treatment of an established capsular contracture
If your right breast is soft and the left breast is firm and hard then you do in fact have a capsular contracture. There are many thoughts as to the etiology of a capsular contracture. When it occurs only on one side then most likely it is related to some type of surface contamination of the implant. This can include things like oil from your skin, lint from the drapes and powder from the gloves. It can also be related to a bacterial contamination. This is more likely from a peri-areolar incision. Treatment options include a capsulectomy with placement with a new implant.
Addressing Capsular Contracture
One of the most common problems is breast capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant. Nicotine users, such as smokers, have up to a 30x increased risk of #capsular contracture.
Saline implants may deflate spontaneously. When the patient has significant #symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening of the capsule may be required or frequently #capsulectomy, which is removal of the scarred capsule, is recommended to ensure adequate pocket dimensions. New implants may then be placed in the same existing position or may undergo a change of #placement frequently from submammary to subpectoral position and, on occasion, the other way around.
Your procedure should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. I suggest you view before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision
Revisionary Surgery for Significant Breast Asymmetry?
Online consultants will not be able to differentiate breast implant encapsulation versus a “high riding” breast implant. Regardless, it seems like revisionary surgery will be necessary to improve your outcome. If, a thickened breast implant capsule is encountered, capsulectomy will be indicated; care must be taken to avoid leaving you with significant rippling of the breast implants after this procedure.
If you are concerned about the position of the right breast implant, capsulorraphy techniques to raise the breast implant position on the chest wall may be indicated.
Best to discuss your concerns and treatment options with your plastic surgeon. Hopefully he/she has significant experience with revisionary breast surgery.
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.