Beginning of a capsular contracture? (Photo)

My original BA was 5/20/16. I developed a torn muscle and hematoma with repair 5/31. Recovery has been great since, however, my affected right breast has changed. I first noticed when bending over that my right breast tissue gets separated from the implant it seems. The bottom feels firm as if flexing my pectoral muscles. I can also tell a difference when standing up and lightly rubbing the bottom of the breast. The photo with the finger shows where the separation is. The other is the left one.

Doctor Answers 3

Possible contracture

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it is difficult to tell from your photos what is occuring. Capsule cotracture can certainly develope in a delayed fashion and presents as a firming or hardening of the breasts. You may be developing a " double bubble", a problem that can occur with submuscular implants. I would recommend a followup with your surgeon to more fully evaluate this.

Breast augmentation, breast implant recovery

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Feeling the implant under your breast is a common phenomena. Not everyone is aware of this. Using a supportive underwire bra can help keep your implant in place. Firming of the implant or breast is called capsular contracture. Early capsular contracture can be treated with Zafilukurst. See your plastic plastic surgeon for his best advise. Good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

Beginning of a capsular contracture

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Thank you for your question!

I hope this answer is informative for you, but for a diagnosis, you have to have an in-person exam by your surgeon.

In general, capsular contracture (CC) can occur at any time, but most cases are documented in under 12 months (i.e., anywhere from 3 months to 12 months post operation). This is because it takes time for the fibrous tissue capsule to form around the implant, and then it will have to scar down (contract).

Capsular contracture can start early when there is significant bleeding, hematoma, or infection or another co-existing problem. Now 6 months have passed since your surgery, so the hematoma may play a role.

Now I need you to know that there are 4 grades/levels of capsular contracture:

Grade I — the breast is normally soft and appears natural in size and shape.

Grade II — the breast is a little firm, but appears normal.

Grade III — the breast is firm and appears abnormal.

Grade IV — the breast is hard, painful to the touch, and appears abnormal.

If your breasts do not appear abnormal, or painful, then you do not require surgery.

In fact, grades 1 and 2 CC do not require surgery, and can be fixed with breast massaging and singulair.

What you also need to know is that the literature review by Dr. Chong & Dr. Deva titled Understanding the Etiology and Prevention of Capsular Contracture, supports that the risk of capsular contracture is related to implant contamination, and bacterial films.

More firmness in the whole of the breast is definitely an initial sign of capsular contracture, but not necessarily when it is localized to the bottom of the breast.

As always, please consult with your board-certified plastic surgeon and their instructions should take precedence over everything you read here.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 reviews

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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.