Reccurent capsular contracture specialist?

Question

My 1st surgery was on 10/13, smooth silicone unders. Implants never dropped. Capsulotomy with implant exchange followed on 2/14. Cc formed almost right away on both sides. Capsulectomy with implant exchange on 11/14. Cc returned less than 3 months later, although I was on antibiotics for a month post op prophylacticly. Please reccomend a revision expert who can resolve this, and who is also very experienced with dermal matrix. I'm willing to travel anywhere as long as I can beat this.

Richard Baxter, MD · Answer

With your unfortunately complicated history, you are wise to consider using acellular dermal matrix and to find someone experienced in revision breast surgery. Although not 100%, the use of Strattice for recurrent capsular contracture has been very effective in my experience and others. There are other things to consider such as location of the incision, size and type of implants, etc.

William Bruno, MD · Answer

Sounds like you may need new implants (textured) with placement of Strattice, an acellular dermal matrix. Capsular contracture can have a very high recurrence rate even with Strattice. You may also have to change your incision site.Best wishes,Dr.Bruno

Afshin Parhiscar, MD · Answer

Dear pink_skyIt is very difficult to have multiple procedures and not achieve the outcome you wanted. Unfortunately capsular contracture is a difficult to predict and although use of dermal grafts may reduce capsule formation, I would be cautiously optimistic, might be too early to tell.Since I don't have a sense of your size and your implant size, have you considered fat grafting for breast augmentation in place of an implant? that might be angle to avoid the problem altogether if your body type is amenable to it.

Payman Danielpour, MD, FACS · Answer

I am sorry that you have had so many complications and so much surgery but I hope that I can lead you down a new path that will hopefully put an end to your complicated course.  Capsular contracture can be and is a very difficult problem but now if corrected properly it can be your last operation for a while.  My partner and I do a lot of revision breast surgery and difficult recurrent capsular contractures with changing of the pocket, capsulectomy, and placement of an acellular dermal matrix.  By taking all of these steps, the recurrence rate becomes less than 1%.  Good luck.

Edward H. Park, MD · Answer

Greetings and Salutations,First off, I am sorry to hear about your recurrent capsular contractures, and I empathize with how frustrated you may feel. My algorithm after one recurrent capsular contracture leads to a detailed discussion of the use of Strattice. I have used Lifecell products for over 10 years - I use Alloderm in 100% of my Breast cancer reconstructive patients who opt for tissue expanders/implant reconstruction. I can safely say that I have seen near zero capsular contracture in these patients. Thus when Lifecell introduced Strattice for cosmetic patients with difficult revisions, I knew it would be quite successful in recurrent capsular contracture cases. I have used Strattice for several recurrent capsular contracture patients of mine with great success. One of the keys is to use a large enough size (Contour 2) of Strattice to prevent the capsular contracture from recurring. Although Strattice can be quite expensive, it is definitely worth the long term investment in my humble opinion. Best of luck!

Brian J. Reagan, MD · Answer

You need to wait a minimum of 9 months to let the process settle down.  I would employ an acellular dermal matrix at this point.  Strattice (porcine) is less expensive than Alloderm (human) and would be my ADM of choice.  All the Best.

Allen M. Doezie, MD · Answer

You definitely have a challenging problem. I would ask your doctor about Singulair, an asthma drug that has been used off-label to help with capsular contracture. Also, I've had experience with some patients who initially seemed very tight, but over the course of a year their contractures softened. Since you have had three surgeries already, give your breasts a rest and see how things go over the next year. You can always have another surgery in the future with dermal matrix (like Alloderm) if they don't soften.

Reccurent capsular contracture specialist?

Answers (7)

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