9 months post op, malposition or capsular contracture? (photo)

I am 9 months post op and about a month and a half ago I noticed my left implant about an inch higher then my right. The bottom has looser skin and I noticed small bands when I raise my arms in the crease where the insition was made. It is not hard or firm and moves around in the pocket. There is no knots and it does not hurt. I feel alittle mucles soreness when I sleep but thats it. My implants are 375cc hp under the muscle. Any idea what this could be?

Doctor Answers 9


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You need to be examined in person to see what the problem is.  Pre-op photos would also be helpful.  Please see your PS.

Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Asymmetry of breasts

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It is always a good idea to post pre-op photos. You have asymmetry now and most likely had it before. This would help establish what could be beneficial for you in the future.

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

9 months post op, malposition or capsular contracture?

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No before photo posted! So a comparison of the asymmetry you had cannot be seen... That is your issue.. To me your result is very good..//

Malposition or capsular contracture?

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Based on your photo and description, you could have either a malposition or capsular contracture. A capsular contracture would tend to make the implant feel more firm than the other side and an implant malposition would not. Capsular contractures tend to get worse with time. Either way, you will probably need another surgical procedure to obtain some better symmetry.

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 90 reviews

Implant shift

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The most common cause of this change would be a capsular contracture although the implant would typically also be firm. Best to return to your PS.

Breast asymmetry

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You should discuss with your original surgeon. You should review your preoperative photos to look at pre existing asymmetry. Your description would not be indicative of a typical capsular contracture (HARDENING). There are many causes of malposition which should be discussed at visit with your plastic surgeon.

Terrence Higgins, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 9 reviews

Change in position of a breast implant after 9 months may be capsular contracture

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Thank you for your question and photograph. I agree it is impossible without an exam and understand what is happening to you.

However elevation and change of position of an implant after 9 months is most commonly caused by a capsular contracture although you say you're implant is not firm.

Please make an appointment to be examined by your plastic surgeon so a proper diagnosis can be made

Breast Implants Change Over Time

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There are three changes that can occur with breast implants over time, leading to asymmetry. These include: drooping ("bottoming out"), capsular contracture, and implant rupture. "Bottoming out" of the implants occur due to pressure of the implant on the breast fold. In some cases, the breast fold may become so disrupted that the implant ends up on the abdomen. Capsular contracture can occur for a variety of reasons, a common possibility being low grade bacterial colonization of the implant. Implant rupture (or "silent" rupture) can occur with silicone implants, also leading to asymmetry.

Of course, several of these issues may occur simultaneously. It may be that the right side has mild bottoming out of the implant, while the left side has a mild capsular contracture (Baker grade II). Taken together, this could contribute to the minor, but noticeable asymmetry. Speak to your plastic surgeon and obtain a second opinion, again from a board certified plastic surgeon. It would not be unreasonable to obtain imaging studies (e.g. MRI) to evaluate the structure of the implants.

9 months post op, malposition or capsular contracture?

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Thanks for your question and the attached photo.

What is apparent is the asymmetry. What is not is the cause. Without seeing before photos, no one can say that this is not the result of asymmetry before surgery. Asymmetry is usually more apparent in larger breasts.

You mention two other possibilities. If both implants are soft and equally so, it would not be capsular contracture. That would leave malposition as an explanation, but of course that is just a description, not a cause.

Discuss options with your surgeon. All the best.

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.