Do you need to correct capsular contracture right away?

Question

One breast is firmer and rides higher than the other one. If it is capsular contracture is it a medical emergency? I do not have the funds for this

Ricardo A. Meade, MD · Answer

Capsular contracture — the excessive scar tissue that can form around breast implants — may ultimately affect the look and feel of your breasts but it’s probably not an emergency. More severe capsular contracture may require treatment sooner, especially if you feel any physical discomfort. However, the firmness and difference in position of your breast could also be part of the healing process if you’ve had breast augmentation in the last 6 months. Breast implants can settle into the breast pocket at different rates over several months. That could explain the difference you are noticing.

Brian C. Reuben, MD · Answer

Thank you for your question.  In short, no, capsular contracture is certainly not a medical emergency.  The only downside is that it can potentially get a little stiffer or tighter, but this does not cause any health issues to you.

George Bitar, MD · Answer

As my colleagues have noted, contracture is not considered an emergency, but the condition may progress over time, and may produce greater distortion of breast shape, as well as physical discomfort.  Oral medications, such as singulair, as well as massage, may produce some improvement, but neither are felt to be primary treatments for the condition, and they do not substitute for surgical treatment.

Christian Subbio, MD · Answer

I think your first step should be an in-person examination with your operating surgeon. He or she needs to see you to get an idea of where you are at this point in time to best counsel you. While surgery is usually indicated for this condition, there is some evidence that certain medications (Singulair) can slow or even reverse early capsular contracture. Discuss this with your surgeon.Best of luck!

Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Michael Dobryansky, MD, FACS · Answer

First and foremost, you should be examined in person by your original surgeon or another surgeon and a diagnosis needs to be made. There are not enough details in your posting and no photos, so a diagnosis is not possible here. If indeed you have a capsular contracture, the implant integrity may be compromised and should be treated with replacing that implant. Other things may be going in as well. You need to have an in person consultation. Good luck!

Larry S. Nichter, MD, MS, FACS · Answer

Treatment for capsular contracture often involves en bloc capsulectomy, complete removal of the capsule, or making the pocket larger by capsular incisions (capsulotomy) with implant replacement. Recent studies suggest that using the same implant may increase the chance of recurrence. Placement of the implant in an new pocket is also often done as well as using textured implants. In the past, closed capsulotomy, in which the breast is squeezed until the capsule breaks, was used but has been associated with implant rupture and other complications and few surgeons use this technique any more not to mention that your warranty will be void. On occasion, the use of a biological fabric like Strattice or Acellular Dermal Matrix (ADM) may be required to prevent continued problems. Although the published risk of capsular contracture is approximately 9–11%, in my practice it is significantly lower after the primary implant placement. Once capsular contracture occurs, the risk of problems with secondary surgery rises to between 25% and 40%. Capsular contractures are lower with non-smokers, and with use of textured silicone implants placed below the muscle. The location of the incision also plays a role. Inframammary incision also has the lowest and periareolar and axillary (arm pit) incisions have the highest capsular contracture rate. Smoking/nicotine use greatly increases your risk for capsular contracture greater than 10 times the incidence of a non nicotine user.

Steven Wallach, MD · Answer

A capsular contracture is not a medical emergency but it is better to treat sooner than later. It can become painful.

Traci Temmen, MD · Answer

Hello Marie and thank you for your question.What you describe in your question sounds like it has the potential to be a capsular contracture. You may notice your breast is not as soft as it once was. Your breast may begin to harden and the physical appearance of the affected breast will change. You will also feel discomfort from the tightening of the capsule. If any of these symptoms persist it is recommended that you visit your plastic surgeon for him diagnose and possibly correct the situation. It is not a medical emergency. Your plastic surgeon will be able to tell you if it needs to be treated immediately or if it can wait. Massaging the affected area may help, although it will mostly attempt to relax those muscles in the chest and reduce any swelling.  Best wishes

Robert L. Kraft, MD, FACS · Answer

I see many patients who have this issue regarding the cost of capsular contracture surgery.  In truth, delaying surgery may result in worsening of the capsular contracture and a more complex procedure, possibly one in which the implant cannot be salvaged.  You should be evaluated to assess the grade of the capsule and then monitored to determine whether it is worsening. That said, this is not a medical emergency in the sense of other conditions which would warrant surgical intervention. You may want to see whether you could finance the procedure through CareCredit or Alphaeon.

Morris Ritz, MB, BCh, FRACS · Answer

It's not urgent to get this done, you might find it stays the same or even gets worse. It's no urgent that you do it right now it can wait. See your surgeon and see what they advise.

Do you need to correct capsular contracture right away?

Answers (16)

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