Uneven Following Capsulectomy on Right-implant Exchange on Both?

Following a complete capsulectomy (for cap con) on my right breast, it is softer and lower than my left. As the capsule forms, will that lift and define my rt breast a bit? I also switched from saline to silicone (with no lift) on both .They are both soft but the left is clearly more defined ,they look uneven and the right one hangs lower. My doctor said that as a normal capsule forms the rt will become more defined and they will look similiar. Has this been your experience? I am really worried.

Doctor Answers 8

Uneven Following Capsulectomy on Right-implant Exchange on Both?

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Hello! Thank you for your question! It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capsule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from ruptured implant vs pain vs simple pocket adjustment, etc). Implants mayor may not be replaced depending on your discussion and reason for capsulectomy.

Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies (in an en bloc fashion) in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Most patients tolerate this procedure very well with minimal downtime. It is typically an outpatient procedure with most being able to resume activities within a few days along with restrictions for a week or so. Many surgeons will recommend a postoperative garment for several weeks postop as well. Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Capsulectomy and Inferior Migration

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    Capsular contracture frequently produces an artificial lift to the tissue.  Thus, capsulectomy produces significant drop in the implant.  The breast will have to heal for at least 6 months to determine if anything else is needed.

Breast appears soft after capsulectomy

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It is normal for the breast to appear softer and looser after a capsulectomy.  sometimes this tightens up a bit over time.  It will take 3-6 months until you see your final results.

Dennis Dass, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 183 reviews


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Without photos, preferably from before and after the recent surgery, it is hard to answer your question. I can say that it is not surprising that these look different early after surgery if one side had a complete capsulectomy, the other not, and that these should change as a new capsule forms on the right side.

Thanks for your question, best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Uneven after unilateral capsulectomy for capsule contracture

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You have some capsule on the left and, now, none on the right.  You should wait a while and it may become more symmetrical.  Don't do anything for six to nine months.

Talmage Raine MD FACS


Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon

Asymmetry following implant exchange and unilateral capsulectomy

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It is hard to give you a definitive answer without an examination and before and after photographs.  If you had a long standing capsular contracture on the right side and this caused some distortion of your breast tissue and only an implant exchange was done on the left side then one would expect some asymmetry.   It is possible that this will improve over time.  Follow your plastic surgeon's advice and  give it time to heal.  If you continue to have a degree of asymmetry it is possible that a revision will be needed. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Uneven Following Capsulectomy on Right-implant Exchange on Both?

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This is a very good question.  There is no answer, only time will tell.  This is the main reason that I think it is important to do a capsulectomy on both breasts so that there is the best chance of getting them as even as can be obtained intra-op, and they can heal together simultaneously.  Of course there are never any guarantee's, no matter what you do, as one can encapsulate, just as yours did.  I would advise you to trust your doctor, and wait 6 months to see how the right breast heals. 

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Capsule removal and final result

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I can not really comment specifically without an exam or photos.. It is difficult to say what the breast will look like in a few months.  Best to follow with your doctor.

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

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.