Rapid Capsular Contracture and Revision Recurrence?

I had my BA and lollipop lift in Feb 2012. My results were a dream. I have now noticed tightening in my right breast. I have 200cc left and 175 cc right. My right breast implant has shrunk to the side of a tennis ball cut in half and is ‘fairly’ tight. It has risen higher to my collarbone. I have under the muscle smooth silicone implants. Might this be from excess bleeding? Or too much muscle work at the gym? I am heading back for revision in Feb 2013, what’s the likelihood of recurrence?

Doctor Answers 5

Capsular contracture

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Tough to say!! These are very small implants and they could have been displaced with your activity level.

New York Plastic Surgeon

Capsular Contracture

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Usually there is no suggestion of a specific cause for a capsular contracture. Exercise if anything should decrease the chances. Hematoma may be a causative factor, but it doesn't sound like you had one. 

The biggest risk factor for capsular contracture is a prior history of capsular contracture. Someone having a revision surgery for CC is more likely to get another than is a woman having a first time augmentation. 

A number of things may decrease the incidence: removing the old pocket, changing out the implant, and, most significantly, using Strattice, an acellular dermal matrix, which seems to have the lowest recurrence rate of CC, but it is quite pricey.

Thanks for your question, best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Rapid capsular contracture and revision recurrence?

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Hello! Thank you for your question! Recurrent capsular contracture is a very difficult problem. Assuming you tried conservative measures in the past - implant massage and may add the medication Singulair and Vitamin E. If these fail, surgical correction may be necessary. 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 capule 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. Irrigating with certain medications may also be if benefit. Some other things that may have been tried include changing the position of your implant, addition of a dermal matrix, or consideration for the the shaped, textured, anatomical gel implants.

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 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. At a 3rd recurrence, it may continue to occur despite all of these modalities and consideration for explantation or living with the contracture are options. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

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Thank you for your inquiry.

Unfortunately, without a physical examination and additional details about your surgery it is not possible to provide you with a solid diagnosis.

So, your situation may be the result of a capsular contracture as well as an implant displacement due to extensive exercising at the gym.

However, capsular contractures forming at about 9 months post-op tend to happen rarely. If this was your case, the chances or recurrence do exist; they differ from one patient to another.

At this point, I encourage you to communicate freely with your surgeon and share with him/her your concerns.

I hope this helps and the best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 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.