Possible Breast Revision? 6 Months Post Op. (photo)

Help! I'm 23years old, I had my BA done at Bumrungrad hospital in August 2012. I'm 6 mth post op and 3 mths ago my R breast started changing. When trying to massage it feels like a hard ball inside and aches quite often. I think I might have Capsular contracture. Someone please give me some insight on there views. Thank you, Renee xx

Doctor Answers 8

Possible Breast Revision? 6 Months Post Op.

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Always best o follow up with your operative surgeon. Yes you have the beginning of a capsular fibrosis. Seek in person aide. 

Breast Implant Encapsulation after Breast Augmentation?

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I'm sorry to hear about the problem you have experienced after breast augmentation surgery. Your history, description of physical findings, and picture are consistent with breast implant encapsulation. Of course, your plastic surgeon will be your best resource when it comes to making this diagnosis clinically.

 Based on your description, it is likely that surgical intervention will be necessary;  this procedure will likely involve removal of scar tissue and reaugmentation surgery.

 Best wishes.

Capsular Contracture Treatment

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   If the breast appears higher or retracted and the breast is firm, then capsular contracture is the likely diagnosis.  Most likely, you will need surgery to remove the capsule and replace the implants.  Capsular contracture is usually progressive and does not get better but worse with time.  Find the plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year.  Kenneth Hughes, MD Los Angeles, CA

A capsular contracture sometimes can be fixed without surgery.

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Although frowned upon, closed capsulotomy is a method to soften the breasts suffering from capsular contracture. It is brief and performed in the office. Although the recurrence rate is high after closed capsulotomy some patients avoid the operating room.

Capsular contracture

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I tsounds like from your description and your photo that you have a capsular contacture on the one side.  You will need to have the capsule removed and a new implant placed.

Breast revision

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Hello. From your picture and description of your right breast it does seem like you are developing capsular contracture. I would talk to your surgeon about a revision as soon as possible. At six months it is safe to go ahead with the revision now if possible.

Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Post-breast augmentation firmness

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Hello 'reneeoh1989', thanks for your question.  Although 6 months is still fairly early postop, your description and photo are consistent with Baker grade 4 capsular contracture, in which you have firmness, distortion, and pain around your implant. There are many theories of why this occurs, including a subacute infection of the surrounding breast capsule, leading to a thick biofilm.  I am not sure what type of implant you have, but another possibility is if you have a small implant rupture leading to your symptoms, for which 6 months seems a bit early for this, but implant rupture can occur at any time.  If you have saline implants, then a rupture would lead to a dramatic deflation within a day.  However, if you have silicone implants and develop a rupture, it could present in a way that you have described.  An ultrasound or MRI should be able to determine if there is a rupture.  Finally, if you feel any fluid around the implant, there is a rare form of cancer called anaplastic large cell lymphoma that has recently come to the attention of the US FDA as having a possible link with breast implants.  Again, it is extremely rare and currently being studied with less than 80 cases known worldwide, but something to consider.  I would recommend seeing your board-certified plastic surgeon to obtain a thorough examination and go through the options with you.  A capsulectomy with implant exchange +/- switching of planes, especially if they are in a subglandular position, could manage the contracture.  Hope that helps! -Dr.92660

Possible Breast Revision?

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From your description and photo, this does appear to be a capsular contracture. Continue massage, and arrange to be seen by your surgeon, who may well suggest some of the non-surgical remedies before recommending a revision operation. These include Vitamin E, ibuprofen, Singulair. If these fail, then surgery becomes a consideration.

Thank you for your question and for the posted photo. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.