Does my breast implant have capsular contraction?

Question

Last week my left breast has been feeling off, felt super extra soft and dropping but physically looks the same Now my left breast feels hard and swollen and maybe even higher than normal. Does feel weird when I lay on them I got Them done in 2021 and silicone

Daniel Careaga, MD · Answer

Capsular contracture is the long-term complication of breast augmentation. It is when the scar tissue around the implant thickens and it can deformed the implant. The implant usually gets pulled up and feels harder, such as you are describing. You are definitely in the right period of time where you can be experiencing a contracture and interestingly, most patients come in complaining of the other breast, feeling too soft and her worried that there may be a rupture when it reality the problem is the harder one which has developed capsule or contracture. Treatments for capsular contracture depends on how advanced it is and may involve medications, corrective surgery or both.

Mehmet Surmeli, MD, FEBOPRAS · Answer

Hi,

Capsular contracture is when your body creates a normal capsule around the implant. This capsule could become thicker and could contract over time to squeeze the implants. So this is called capsule contracture, and this is one of the main causes of reoperation in breast implant patients.

When we check the signs of capsule contracture, it is uncommon to observe it in the early few months following the surgery. Typically, it starts 1.5 to 2 years after surgery. So it usually happens after 8 months and not later than the third year after surgery. But, there are exceptions, these are some generalizations.

When we check the early signs, such as the firmness that the patients begin to feel on their breast, patients usually report that on one side, the breast feels hard and firm, and it looks like the implant looks a little bit higher than normal in position. There could also be associated distortion in the shape of the breast, which may look a little bit constricted. In addition, there could be pain or not, depending on the breast deformity and the associated pain; this may require a reoperation.

In reoperation of the capsule contracture, we usually try to remove that pathologic capsule altogether, and we try to replace the implants as well, particularly textured implants, because if you check the implant, you see that the outer capsule of the implant is in an unbelievable close relation with the capsule itself and the overall texture does not look very nice on the capsule as well. So, in most capsule contracture revision cases, we try to replace the implants, and we try to exchange the implants as well.

It is reported that the pain is relieved after this revision surgery. There's a special grading system, it's called the "Baker Grading System for Breast Implant-Associated Capsule Contracture," and there are other kinds of conservative treatments for early firmness that patients may feel on their breasts, such as massage, as some anti-asthma medications that are also used in the treatment as well, depending on the severity of the situation. Still, we make a plan for the revision.

My comments and recommendations are solely based on your text and are subject to change. I always recommend a face-to-face consultation with a specialist to plan the treatment. Best wishes, Dr. Surmeli.

Chet Mays, MD · Answer

Thank you for your inquiry!   I would definitely schedule an appointment with your physician to have professional advice.  We would love to meet with you to discuss your options.  Schedule a consultation with a Board Certified Plastic Surgeon.

Morad Askari, MD, MBA · Answer

Thank you for your question. The symptoms you're describing may indicate capsular contracture, but it is important to consider other possibilities such as implant malposition, rupture, or localized inflammation. I recommend scheduling an in-person evaluation with your surgeon as soon as possible. Your surgeon may suggest imaging tests, such as an ultrasound or MRI, to assess the condition of the implant and the surrounding tissue. Additionally, it is important to monitor any changes in breast appearance, sensation, or discomfort.

Ted Eisenberg, DO, FACOS, FAACS · Answer

You might also need an ultrasound and MRI to determine if your silicone gel implant is ruptured, if you haven't had one since your surgery. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Wayne I. Yamahata, MD · Answer

With your symptoms a capsular contracture would be in the differential diagnosis. To provide a definitive diagnosis requires an in person physical examination. If your surgeon is available, a follow visit to him or her would be warranted. Otherwise seek a consultation with a board-certified plastic surgeon in your area.

Patrick Felice, MD · Answer

It sounds from what you describe that you are experiencing a capsular contracture. You should have this examined as soon as you can.

Daniel Barrett, MD · Answer

Dear jtruong1367,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ira H. Rex III, MD · Answer

You may have capsular contracture, but there may be other reasons for your findings.  It seems that you should get and evaluation by a board certified plastic surgeon to evaluate the situation.  You may or may not need and ultrasound depending on your exam.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!Unfortunately without an exam and standardized pictures it is hard to figure out the cause of your issue.From your description the issue could be secondary to capsular contracture vs a delayed seroma or similar fluid collection. each issue comes with its own set of tests and management. I would recommend that you consult with your plastic surgeon to come up with a diagnosis and plan that will work for you.I hope this helps, Best of luck!

Does my breast implant have capsular contraction?

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