Question about revision for capsular contracture in right breast? (photos)

Hello, I had a BA done in July 2012 and around September I noticed that I developed CC in my right breast. Im not in pain but my breast sits higher and it feels tight. What exactly needs to be done to fix this? Will Accolate help to prevent from CC returning? Can I get bigger implants for a little more fullness & what size would you recommend? I have 450ccs silicone unders. I was suggested 550/600ccs but 600 makes me a lil nervous. I started with an A cup (mommy of 2) and now I am a D cup. Thank you!

Doctor Answers 9

Strattice for capsular contracture

Treatment of capsular contracture usually involves replacement of the implant and a capsulectomy (surgical removal of the scar capsule.) The best way to minimize the risk of CC returning is to also place Strattice or Alloderm. If you are going larger, this can help add support and coverage which will be important after capsulectomy.  Accolate may help but not much in my experience.

Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

Capsular contracture

I would not recommend going any larger.  It is impossible to tell if you gave capsular contracture from the photos.  It looks like one implant is riding a little higher than the other.  That may not be an indication of capsule.  The higher implant may just need to be lowered slightly to improve the symmetry.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 24 reviews

Right capsular contracture

Hello Proud Mommy-
It appears that your surgeon did very well with your breast augmentation, as reflected in your left breast. The right breast has just contracted in the lower breast pole more than desired and this can happen with any surgeon and patient. There are endless discussions of what can or might cause CC and even more on how to prevent CC from occurring. The simplest thing to say is to follow what your current plastic surgeon recommends to minimize CC from occurring again. The good news is now he/she only needs to operate on the lower right breast and therefore recovery should be simpler. 
Good luck.

Mark Anton, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 35 reviews

Question about revision for capsular contracture in right breast?

   Anterior and posterior capsulectomies of the breast with capsular contracture is standard surgical treatment.  A dermal matrix can be utilized as well to reduce recurrence risk.

Kenneth Hughes, MD

Los Angeles, CA


Thank you for the question and picture.

I do believe that the capsular contraction is very visible. The size of the implant that will make them look better, would be the 550 cc's.

Good luck
Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 241 reviews

Capsular contracture

There are many causes of capsular contracture which is an unfortunate complication with breast implant surgery. You would need to remove the capsule from the right breast and place the new implant in the appropriate lower position.

Increasing size would be possible at the same time. Your surgeon would need to know the profile of the implant as well as the volume to help guide you to an appropriate proportional size.

Seek out a board certified plastic surgeon to evaluate you and help decide the right volume and profile for you.

Good luck and I hope this was helpful.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
4.9 out of 5 stars 121 reviews

Capsular contracture

Dr Chong has given you a very through answer though I might add that the use of a protein matrix in reoperations for capsular contracture markedly reduces the recurrence rate and in my hands literally to zero

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 58 reviews

Natural history of CC

CC (capsular contracture) is one of the more troublesome complications of breast implants.  The Baker classification I-IV rates how firmness, shape change and pain.  Your photos and history suggest Baker II-III, which most PS will manage medically, with Accolate or Singulair, both of which are "off-label" uses of asthma medications. The postulate is to decrease your body's inflammatory (foreign body) response to the implant.  In my experience, these drugs are 40-50% efficacious with relatively well tolerated side effects.  If the firming continues despite Accolate, causing progressive hardness, upward displacement and pain, your PS will probably suggest surgery: open capsulectomy, implant exchange and possible site change.  Upsizing your implants to 550cc may achieve your goals, assuming the base diameter or "foot print" matches your chest width.  Despite optimal surgery, the risk of recurrent CC is present :( Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 56 reviews

A Physical Exam Is Required

Hello Proud Mommy,

I have to agree with Dr. Edelson, it’s impossible to know for sure if you have Capsular Contracture until a physical exam is performed. However, if it feels tighter to the touch and has risen higher, chances are it is a C.C.

Size is always a personal preference, but I think the size you’re currently at looks wonderful on you.

A Board Certified Plastic Surgeon will be able to give you more information after a physical exam. If you are indeed experiencing capsular contracture, a simple implant extraction and clearing of the contracted tissue should be all that you need.

There are various degrees of capsular contracture (Baker Scale). Grades 1 and 2 are generally not severe enough to warrant insurance coverage. However, Grades 2 and 3, which cause visible deformity, pain and have the potential to obstruct a mammography may be covered by your insurance. All good things to know in making a surgical revision decision.

Hope this helps & good luck,

Dr. Franco-Webb

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.