Capsular contracture? (photos)

Asking again, On 5/27/16 I had BA done, 540cc smooth saline under muscular. Now, 4 mo post op and they look so different. My right feels really soft and natural, my left feels different. No pain or hardness, my right upper pole looks/feels much fuller than my right. My PS said that I shouldn't worry as the left breast has not settled and to massage it in downward stroke. I'm getting nervous that I will need a revision. Is there anything I can do or avoid to help the breast drop into its pocket?

Doctor Answers 4

Asymmetric breasts after augmentation

You may get some improvement over time with vigorous and forceful massage of the left breast.  However, I feel it is likely that you will need a surgical adjustment of the left side at some point in order to resolve the issue.  I would recommend giving it around 6 months total after the surgery.  If it is firm in that side compared to right, you could consider trying Singulair 10 mg po daily for the next 90 days to see if that helps.  A doctor would need to prescribe that for you.  It may help soften the capsule.You had asymmetry pre-operatively, so you will likely have some degree of post-operative asymmetry no matter what is done.  However, adjusting the left implant at some point should get you much closer to ideal.

Chattanooga Plastic Surgeon
5.0 out of 5 stars 22 reviews

About 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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Capsular contracture?

I share your concern for the asymmetry. Best to give it time, but if after 9 months of no acceptable change- I would consider re-establishing the left pocket in order to achieve a greater acceptable appearance.

Capsular contracture?

For sure asymmetry is noted. But best to seek only in person examinations to determine if cc, bottoming, both?

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