Does capsular contracture ever come back worse after revision?

Question

I'm going to have revision surgery. I am getting strattice and textured sientras. My ps said I have a pretty good shot at success, but he scared me when he said that it is a possibility for cc to come back worse. Mine are grade 3 and grade 4, but I am lucky that they dropped before they hardened and are not really deformed as I've seen some. Does anyone have any experience with cc coming back worse and the patient totally regretting doing the revision?

Tom J. Pousti, MD · Answer

Thank you for the thoughtful question. As you know, encapsulation can be quite frustrating for everyone involved. Based on your description, it sounds like you and your plastic surgeon are doing everything possible to help prevent recurrence; unfortunately, recurrence is still a possibility.  In my experience, utilizing steps such as sub muscular conversion, the use of acellular dermal matrix and fresh implants, the use of a no touch technique, the use of  peri operative antibiotics and postoperative anti-inflammatory/massage, the chances of success are quite high. I have had cases of recurrence of encapsulation but none ( that I know all)  that were worse than our starting point. Best wishes for an outcome that you will be pleased with.

S. Larry Schlesinger, MD, FACS · Answer

Plastic surgeons know quite a lot today about what causes capsular contracture and how to treat it.  However, capsular contracture around foreign objects in the body, such as breast implants, artificial hips and pace makers, is not completely understood.Two possibilities occur to me.  One, that your capsular contractures are secondary to non-pathogenic bacteria in your implant pocket which may not be completely eliminated during your secondary breast augmentation procedure.  Another possibility that comes to mind is that your body's immune system is very strong and will form a thick capsule around any foreign body.  Either of these two possibilities can lead to a second and potentially worse capsule than you presently have.Statistically, if you have chosen one of the excellent Board Certified plastic surgeons in San Francisco, then you should have a great result without re-encapsulation.

Richard Baxter, MD · Answer

The most effective method of preventing recurrent capsular contracture is essentially what you are doing: Capsulectomy, implant replacement with a textured implant, and Strattice. Your chances of long term success are very high with this approach.

Stuart A. Linder, MD, FACS · Answer

It  can come back even worse after revision surgery. Some women have a propensity for further scar tissue formation after each surgery.

Milind K. Ambe, MD · Answer

It sounds as though your plastic surgeon has a good plan for this revision.  That being said, no one can know for sure if your body will develop encapsulation again.  I also find that incision placement in the inframammary fold region (vs periareolar) helps prevent recurrent cc.  Using Singulair right after surgery is often also warranted.  Best of luck to you

Does capsular contracture ever come back worse after revision?

Answers (6)

Answer: Yes

Answer: Yes

Answer: Capsular contracture recurrence

Answer: Capsular contracture recurrence

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Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

Does capsular contracture ever come back worse after revision?

Answers (6)

Answer: Yes

Answer: Yes

Answer: Capsular contracture recurrence

Answer: Capsular contracture recurrence

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.