How common is repeat capsular contracture when replaced with smaller implants after capsulotomy? (Photo)

Capsular contracture can reoccur. It appears your implants are in front of the muscle. The implants will need to be placed behind the muscle.

Best Wishes,

Gary Horndeski, M.D.

Capsules can occur again, but going smaller is helpful. Close follow up after surgery and using breast bands and ultrasound treatments can be helpful. Sometimes mesh is needed as well if a reoccurrence occurs.

The cause of capsular contraction is not always known.
Individuals who develop recurrent capsular contractions may likely have contamination with Staphylococcus epidermidis bacteria.
This bacteria is very slow growing, cannot be detected by culture and cannot be treated with antibiotics.
The bacteria create a biofilm or slime that causes chronic inflammation, and is most likely the main reason in individuals who have recurrent capsular contractions.
My personal preference is to treat significant capsular contractions with a complete, preferably circumferential capsulectomy.
Capsulotomy alone is generally insufficient.
Capsular contraction is not directly correlated with implant size.
There are other reasons why some individual patients form capsular contractions.
Excessive amount of blood around an implant during the primary procedure can increase the chance of cap or contraction.
When that’s the case the chance of recurrence should be less bleeding as well controlled during capsulectomy surgery.
Unfortunately, we don’t have tests that can differentiate what the ideology is for capsular contraction.
The best we can do issues, good clinical judgment, and experience to manage each case on a case by case basis.
I generally recommend patients have multiple consultations before choosing providers.
If you’re happy with your current provider and field that their care is appropriate, then stick with your provider.
If you want a second opinion consultation, then schedule those as in person consultations with other plastic surgeons in your community.
For second opinion consultations come prepared bring with you a complete set of proper before and after pictures and a copy of your previous operative report.
Best,
Mats Hagstrom, MD