Removing capsular contracture, not wanting lift, should I stay with same size? (Photo)

Have implants in for 11 years and I am a 34C, small frame, 5'6, 118 pds. After two kids, breast feeding, some capsular contraction going on. I really would like to be slightly smaller but being told that if the capsular's are removed and implants sitting lower than the size wouldn't appear so large like now. Too small and I would need a lift. Is this accurate? debating over gel 330 or 350cc's. Have saline 350cc's filled to 325 now. Wishing I could go to 280/300s.

Doctor Answers 12

Removing capsular contracture, not wanting lift, should I stay with same size?

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Based on your photos, I believe you would do best with smaller implants, Strattice ADM placement to cover the thin areas, and to help avoid the return of your capsules and a mastopexy.  You do not mention whether your implants are over or under the muscle but they appear to be over the muscle.  If this is the case, I would recommend reaugmentation under the muscle with the above-mentioned procedures. If you were to just remove the capsules and replace your current implants with smaller implants, your breasts would likely look more droopy, especially on the right.  While many women are opposed to mastopexy scars, most of my patients heal very well and are happy they had a lift performed to regain a more perky appearance.  This may not be possible in you without a lift.  

This information does not replace a thorough in-person consultation with a board certified plastic surgeon who is very familiar with various options for treating capsular contracture.  Thank you for your question and best of luck to you.

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

About Capsular Contracture

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One of the most common problems is breast capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant. Nicotine users, such as smokers, have up to a 30x increased risk of #capsular contracture.

Saline implants may deflate spontaneously. When the patient has significant #symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is r#ecommended to ensure adequate pocket dimensions.

New implants may then be placed in the same existing position or may undergo a change of #placement frequently from submammary to subpectoral position and, on occasion, the other way around.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Capsular contracture

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You can have the capsules removed and the implants replaced.  However, I think you would also benefit from a lift because your nipples are too low.  The lift part can be done at the same time or you can wait and see what your breasts look like with the capsulectomy only, then decide if you need the lift.  It can always be done at a separate stage.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Capsular contracture

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Thank you for your question.
This is common to want to down-size especially after breast feeding.
Capsular contracture also confuses things since your implants are very high-riding and your breast tissue is lower.
I would recommend choosing implants that fit your body (or smaller) and using a lift to tighten the breast. 
You will also have to decide how to treat the capsular contracture by removing the capsule and replacing implants in a different plane, utilizing adm, etc
Your options are best explained after an in person examination.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Capsular contracture

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Saline breast implants have an increased rate of deflation after seven years of implantation. So your present saline implants do not have the volume that you had 11 years ago. They most likely  have a lesser volume.

In addition your breasts require a lift.

If you chose to not have a lift then your option is to have capsular revision, removal and replacement of breast implant and chose larger breast implants, not smaller ones.

Breast Capsulectomy and Implant Revision

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Without an examination, it is impossible to give specific advice. However, you appear to have ptosis of the breast over the implants. The capsular contracture appears to be a secondary problem. If this is the case, you will not achieve normal appearing breasts without a lift, no matter what size implants you use. Make sure you see a board certified plastic surgeon with significant experience in implant revision.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

To lift or not to lift that is the question

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Based on your photograph, you have a combination of superior malposition of your implants caused by capsular contracture and some degree of breast ptosis(droop). I must give the disclaimer that my on line advice is flawed by not having the benefit of an in person exam. In your case, the breast is often artificially elevated by the capsular contracture. When you remove the capsule, the breast will further descend. it has been my experience that your treatment plan would include an inferior partial capsulectomy, reaugmentation with silicone implants, and a lollipop mastopexy (lift) to get the best result. lease consult with a plastic surgeon with a significant amount of experience in revisionary breast surgery. All my best

Paul E. Chasan, MD
Del Mar Plastic Surgeon
4.9 out of 5 stars 46 reviews


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Thank you for the photos and question but an in person examination is really needed to say what might give you the best result so see some experts in your area

Dr Corbin 

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Removing capsular contracture, not wanting lift, should I stay with same size?

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Thank you for the question and pictures. You are asking good questions, that online consultants cannot answer specifically enough to be truly helpful. My best suggestion: seek consultation with board certified plastic surgeons who can demonstrate significant experience helping patients with revisionary breast surgery. Then, communicate your goals carefully as well. In my practice, I find the use of goal photographs very helpful. Avoidance of terms such as "slightly smaller" or  "C or D cup" is also helpful.
After careful communication of your goals with your plastic surgeon, you will be able to come up with the best plan (probable capsulectomy/capsulotomy, removal/replacement of breast implants, possible breast lifting), to achieve your goals. You may find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you learn more. Best wishes.

Lift or no lift post breast aug 11 years ago

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Hello Reena39-

One can view the breasts has having two basic characteristics that one is trying to get in balance with each other: 1. the breast shape is determined by the skin envelope and 2. the breast size is determined by the volume of the underlying tissue and implant. 

It is more difficult to say with certainty with only photos, but it appears that you would greatly benefit from a full lift (mastopexy) especially since you would like to go smaller in volume. You have a generous skin envelope and that needs to be tailored down to match your volume and lean body. 

The scars of a lift usually heal well and are usually a great tradeoff for a better, more youthful, perkier shape. Look at your surgeon's lift photos well and make sure you have chosen wisely. 

Best of luck.

Mark Anton, MD, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 38 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.