Why Are My Breasts Still Very High After Full Capsulectomy? (photo)

Since my breast never dropped after my 1st surgery, I had a full capsulectomy and they replaced my 350cc under the muscles with 400cc Siltex textured also under TM. I had heavy bleeding during surgery so they put drains in for 7 days and said there was just a small hematoma left. Now at 6 wks my breast looks almost as it did before surgery, very high and with a saggy bottom and side. My ps wants to see me in 1 month and said to massage but I'm scared I will be forced to have another surgery.

Doctor Answers 6

Upper fullness after capsulectomy probably means probably more than just an implant in the pocket.

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From the projection you appear to have from the profile shot, it looks like there is more than an implant in your pocket......hematoma or seroma most probably.  A drain won't usually prevent a hematoma if the pocket is not dry at the end of surgery from my experience.  You need to be re-explored at the least unless you are first checked with ultrasound or CT/MRI.  Leaving blood in there will almost guarantee a hard capsule because blood in the tissue is irritating and stimulates more scar formation.  A seroma will keep the pocket stretched out.

Seattle Plastic Surgeon

Breast implants still too high

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At six weeks post-op, it's still early and your implants may still settle into a more natural position. Unfortunately, you may have developed capsular contracture again which will have to be treated with surgery. You could also discuss the use of Accolade with your plastic surgeon. It's a medication that has been beneficial in some cases if early contracture. Hematomas have been linked to capsular contracture, but it's hard to draw a completely linear relationship. 

Asaad H. Samra, MD
New Jersey Plastic Surgeon
5.0 out of 5 stars 43 reviews

Untreated hematoma increases the incidence of capsular contracture.

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One of the predisposing factors capsular contracture is in inadequately treated hematoma. It's possible that if the hematoma after capsulectomy was inadequately treated it might increase the risk for a recurrent capsular contracture.

Hematoma after surgery

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How does your surgeon know there is a little hematoma? If it was based on physical exam, an ultrasound might be helpful to look at the space around the implant. If there is a lot of blood or fluid, then it will need to be drained. Wearing a bandeau strap might help the implant settle slightly, but it may very well require further intervention to be symmetric with the other side.

Dana Goldberg, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 41 reviews

Implant issue

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Without an exam it is difficult to say. Do you still have blood around the implant?  Is there a seroma?  Is it muscle spasm?  

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

Implant problems

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You don't look right for sure. Probably related to blood around the implant. Leaving it untreated increases your risk of CC again. Are you sure yours is a BC Plastic Surgeon as most would not pass this off for a month?

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.