Can peptide BPC-157 or Ultrasound Help Grade II Capsular Contracture?

Question

Hi doctors, I had primary breast augmentation with Mentor silicone implants placed under the muscle in March 2025. About 6 months later, I developed Baker Grade II capsular contracture, primarily in my right breast. It feels noticeably firmer than the left but is not significantly distorted or painful. My plastic surgeon currently recommends observation rather than revision surgery and does not believe there is sufficient evidence supporting peptides or therapeutic ultrasound. So far I have: 1. Completed 2 months of Singulair (montelukast) with no improvement in firmness or softness. 2. Had breast massage every other week for 3 months, also without improvement. Since my warranty would not cover revision surgery unless the contracture progresses to Baker Grade III/IV, I'd like to explore other non-surgical treatments. I would appreciate your opinions on: 1. BPC-157 (or other regenerative peptides): Have you seen any clinical evidence or personal experience suggesting these can improve Capsular Contracture? Are they more likely to help early inflammation than mature scar tissue? 2. Therapeutic ultrasound: Have you found ultrasound therapy effective for softening Grade II Capsular Contracture? 3. Are there any other non-surgical treatments with reasonable evidence that I should consider? Would you recommend continuing Singulair or massage despite no improvement so far? Thank you for your time and advice!

Mert Demirel, MD · Answer

Capsular contracture is one of those situations where it is very understandable to want to do something early, especially when the breast already feels noticeably firmer, but we also have to be honest about what is supported by evidence.
For BPC-157 or similar “regenerative peptides,” I would be very cautious. At this time, there is no good clinical evidence showing that BPC-157 can reliably soften or reverse capsular contracture around breast implants. The problem in capsular contracture is not just simple inflammation; it is a fibrotic scar capsule that has organized around the implant. In very early inflammatory phases, some treatments may theoretically influence inflammation, but once firmness is established, peptides are not proven to remodel that capsule in a predictable or safe way. I would not recommend relying on BPC-157 as a treatment for capsular contracture.
Therapeutic ultrasound has also been discussed for many years, and some surgeons or therapists may have anecdotal experience with it. However, the evidence is limited and inconsistent. For a Baker Grade II contracture, ultrasound may sometimes make the breast feel temporarily softer or more comfortable, but I would not present it as a treatment that reliably reverses the capsule. If it is used, it should be done carefully and only with your surgeon’s knowledge, because the implant pocket, implant position, and tissue thickness all matter.
Regarding Singulair, montelukast has been used off-label by some surgeons for early capsular contracture, especially when the process seems inflammatory. But if you have already completed two months with no noticeable improvement, the chance of a major late response becomes lower. Continuing it longer is a decision to make with your own doctor, also considering possible side effects. It is not a medication I would continue indefinitely without a clear reason.
Massage is similar. In the early postoperative period, depending on implant type, pocket, and surgeon preference, massage may have a role. But once a capsule has become firm, repeated massage usually does not truly break or reverse the capsule. If three months of massage has not changed the firmness, I would not expect dramatic improvement from simply continuing the same approach.
For a stable Baker Grade II contracture that is not painful and not visibly distorted, observation is a very reasonable recommendation. At this stage, surgery can sometimes create more problems than it solves, especially if the appearance is still acceptable. I would usually monitor whether the breast is stable, becoming progressively firmer, becoming painful, or starting to distort in shape. Those changes would be more meaningful than firmness alone.
The most important point is to rule out factors that can contribute to progression, such as implant malposition, fluid, low-grade inflammation, hematoma/seroma history, or infection-related issues. If the firmness progresses, imaging and a detailed examination may be appropriate. But for Grade II contracture, the most evidence-based approach is often careful follow-up rather than aggressive treatment.
So my honest answer would be: I would not consider BPC-157 an evidence-based treatment for capsular contracture; I would view ultrasound as optional and experimental rather than reliable; and if Singulair and massage have already failed to improve the firmness, I would not expect them to suddenly create a major change. Continued observation with your plastic surgeon is a sensible plan unless the breast becomes painful, distorted, or clearly progresses toward Baker Grade III/IV.

John LoMonaco, MD, FACS · Answer

Capsular contracture is a frustarting problem because we still do not know eaxctly what causes it, or why it develops when it does.  There is no cure-all treatment.  Singulair has not been shown to work consistently, nor have any of the newer peptides.

Ultrasound has (in some research studies)  been shown to help with discomfort and tighteness, but this doesnt always make the breasts look better.  My experience with it has been mixed but starting in the early stages has been most helpful.

Surgery remains the gold standard for treatment.

You'll need to specifically ask your doctor about continuing the medication...it can cause liver problems and it does require blood work periodically so stopping it is a decision you need to mmake with your surgeon.

Can peptide BPC-157 or Ultrasound Help Grade II Capsular Contracture?

Answers (2)

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