Do I Have Capsular Contracture Even if my Breasts Are Very Soft- Not Hard or Tight? (photo)

I am one year post-op. 300 silicone Natrelle implants- 32B to 32D. The size seems perfect for my 117lb frame. The left breast never dropped completely- it is very soft. I continue to massage..I wore the band for months, etc. During my last appointment, my surgeon mentioned coming back at one year (my appointment is next week) to discuss opening up the incision to release the implant. I am assuming a capsulotomy. Is this my only option? My incisions healed nicely and are barely noticeable.

Doctor Answers 16

No capsular contraction, but release of inferior pocket necessary to drop breast implant

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Thank you for your question and photograph. Since your breasts are soft you do not have a capsular contraction. Your surgeon is correct that a small revision to drop the high implant is all that is required.

You are correct.

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Hello, Thank you for the photos. You are correct in that you are unlikely to have a capsule contracture with a soft breast. It is more likely that the lower portion of the pocket needs to be released. I would not worry about the incision since it should heal just as good as before. All the best, Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

Breast augmentation revision

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In my opinion part of the asymmetry you see after surgery was present before surgery and affected your end result. The other part is due to the implant being a little high on the left. Although capsulotomy and implant repositioning will improve the asymmetry to some degree I think some release of the left inner lower quadrant breast tissue will be needed to fully improve the breast contour/symmetry.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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What your doctor's explaining is accurate. Removing the capsule is only 2 let the implant drop into its pocket. At this point it is your only option.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Capsular Contracture #breastimplants

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I can't say if you have a contracture or not from pictures but what you describe is a high riding implant that never dropped. In that case you are looking at a capsulotomy one year out to lower the fold on that side. It is a fairly straight forward operation and does not take very long to do. At one year if it has not dropped it will not. The capsule has fully formed and you can not encourage the implant to fall any longer.

A soft breast does not have a capsular contracture

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Thank you for your question and photographs. If your breast is soft, you do not have a capsular contracture. Your left breast is sitting a little higher than the right causing the asymmetry. I agree with your surgeon that lowering the pocket a little on the left can resolve your issue and, often times, can be done as a fairly minimal office procedure. Good luck.

Breast asymmetry

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Each breast is slightly different as seen in the photos and although the left one is sagier the fold appears higher in the photo.  A small release as your surgeon suggests may do the trick.  Good luck.

Do I Have Capsular Contracture Even if my Breasts Are Very Soft- Not Hard or Tight?

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Based upon the posted series of photos you have a poor surgical result. Asymmetry to shape, location is noted. Best to obtain IN PERSON Second opinions from boarded PSs in your city. 

High Riding Implant

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Generally, an implant that is soft is not encapsulated.  Capsular contracture is a tightening of scar tissue around an implant.  This typically causes the implant to ride high and feel firm to exam. Another possibility in your case is that your implant and pocket are too high. If this is the case, it would require a pocket release (capsulotomy) to allow room for the implant to drop into place.  It is a relatively simple procedure to release the pocket and adjust the implant position.  Best of luck!

Can soft breasts have capsular contracture?

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Most likely you do not have capsular contracture if your breasts are soft. You just have a normal capsule and unfortunately the implant did not drop as much on the left as the right.It is not a big deal to have the left capsule opened a little to allow the implant to move down. I typically do this in my office under local anesthesia with mild oral sedation (ativan) and my patients tolerate it well. The main risk is possible rupture of the implant while it is being retracted out of the way to release the inferior capsule (though this risk is small).You don't need to wait until one year out to have this done. However if you don't want it done, then don't. You look reasonable right now. I hope this helps.


Daniel Medalie, MD

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.