Texture or Smooth Implant to Prevent Capsular Contracture Only on my Right Side of Breast?

Please help, How do I tell the implant was place under or over muscle? my first time implant was have mild capsular contracture. For second time replace with new implant and the cut was right at nipple, I massaged after the third day and cause the cut was open & bleeding, couple weeks I saw the nipple was pull in right at the cut and had capsular contracture. I planning to redo for third time with different doctor and he recommend to use the texture implant which I am didn't like.

Doctor Answers 8

The answer isn't texturing

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the answer is 1) not using the nipple incision, 2) using the underneath incision, 3) making sure the implant is behind the muscle 5) considering Strattice, 6) bloodless and gentle surgery, 7) removing the entirety of the capsule, 8) clinically proven intraoperative antibiotic irrigation.

Texturing probably wouldn't make any difference at all.  In fact there is experimental evidence to suggest it may increase the chance of recurrent contracture because it has more interstices in which the bacteria which are the culprits in contracture can hide...


The link below will provide you with all the information you need, FAQs, and photographs of capsular contracture.

Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Texturized implants do not decrease capsular contracture.

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Objective comparisons between texturized and smooth implants demonstrate no difference in the rate of capsular contracture. Texturized implants are more inclined to failure furthermore. I don't know why they still sell them.

Contractures with implants

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can be a vexing issue.  Much of what I suggest depends on knowing exactly what was done in your past.  Your description is hard to interpret but if contractures were a real problem, my preference is a new pocket, new implant, and if above the muscle, a textured anatomic implant what won't move around naturally when you lay flat.  Good luck!

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Texture or smooth implant for capsular contracture

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If placed under the muscle, the evidence for one vs the other implant I think is equivocal.  I prefer smooth implants myself and if you have a propensity to develop a capsule, then strattice may help.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Preventing a capsular contracture

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I am not sure of your exact problem or the sequence of events.  There is evidence that a textured implant can be beneficial in preventing a capsular contracture.  If you have tried everything else then it is a reasonable choice.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Texture or Smooth Implant to Prevent Capsular Contracture Only on my Right Side of Breast?

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The best way is to call your surgeon and/or ask for a copy the operative record. Your surgeon can easily tell on exam. With under the muscle implants, the implants will move when the pectoral muscles are flexed. If the implants are above the muscle they should be moved to below. If below, and possible even if above, consider the use of Strattice to minimize the chance of another recurrence. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Use Strattice for recurrent capsular contracture

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When you have had surgery for a capsular contracture and it recurs again, I think it is important to do everything possible to minimize the chance of another recurrence. The most effective thing in my experience is the use of an acellular dermal matrix like Strattice. You should note some movement if the implants are under the muscle, either flattening across the upper breast or upward movement of the implant. Textured may be better than smooth for contracture but you would not need them if you have Strattice, which is more effective.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Capsular Contracture

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Since you have had a recurrent capsular contracture, switching to a textured implant can help.  Studies have shown that capsular contracture is less with a textured implant.  However, textured implants do have a thicker shell and can be more palpable.  Placing the implant under the muscle is another step to take to help reduce capsular contracture.  One way to tell if your implant is under the muscle is to flex your pectoralis muscles.  If you see the implant move upward and outward then it is most likely under the muscle.   There are certain medications that can help reduce capsular contractures, but once they are established it is difficult to reverse without surgery.  Finally, another intervention  would be to use a tissue matrix within the breast pocket after capsulectomy.  One such material is Strattice.  This has been shown to reduce recurrent capsular contracutre significantly.  I have had success in preventing further contractures in my patients.  Thanks for the question!

Steven Svehlak, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 31 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.