Breast Augmentation too perky! Will they look more natural after pregnancy/breastfeeding?

Question

Hi RealSelf! I had a ba done 6 years ago and went from a 32A to a 34C with 350cc moderate + saline implants. About a year postop, I developed a mild degree of capsular contracture and notice they sit very unnaturally on my chest. For lack of better words, they look like two balls and don’t have a natural sloped profile at all. I was wondering, will they look more natural after pregnancy/breastfeeding? My husband and I are trying and this issue has been on my mind

Alan Gonzalez, MD, FACS · Answer

Dear @2perky thank you for your question. It is important to be careful of a contracture, make controls of this process with your surgeon. Breasts tend to grow by enlarging the mammary glands when breastfeeding, which may cause some laxity in some cases or for some patients since not all patient skin is equal. For more information and recommendations is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS

Douglas L. Forman, MD, MBA, FACS · Answer

While it is unusual to develop an early capsular contracture 1 year following breast augmentation, it is not unheard of. There may be many factors that have contributed to your capsular contracture such as if the implants were placed over the muscle or if you had blood remaining in the pocket at the time of the augmentation or if you developed an infection anywhere in your body after surgery. Also, patients have reported developing capsular contractures after undergoing dental procedures with the bacteria that circulate through the body that settle on the implants and initiates the cascade for an eventual capsular contracture. Therefore in our practice, for the first 2 years after breast augmentation, including revisions, we recommend that patients take a dose of oral antibiotics prior to any dental procedure, including cleanings. While there is no good plastic surgery data or literature on this topic this recommendation is similar to the orthopedic literature for patients with knee and hip replacements. Also if patients develop a capsular contracture, Singulair, a prescription asthma medication that blocks inflammation, has been shown anecdotally to at least stop the progression of a capsular contracture and even in some cases reverse it.
With regard to your question about pregnancy creating a more natural appearance, this is unlikely. Most likely your breast will go through some changes with pregnancy and subsequent breast-feeding, if you choose to breastfeed, however I do not see an instance where this would reverse a capsular contracture. Conversely, following breast-feeding the breast typically involutes and your capsular contracture may become more obvious. You already stated that it looks like a ball on your chest and it may then look like a ball that hangs in the bottom of the breast mound if the implant is in front of the muscle. If the implant is behind the muscle then the ball will sit up high on the chest and the breast mound will fall off of the front of the implant and the breast will hang in a dependent fashion.
At this juncture it is recommended that you follow-up with your original board-certified plastic surgeon so they can evaluate where you are now and give you additional information about your implants going forward. Typically patients have implants changed several times over the course of their lifetime and it may be in your best interest to consider this option in the form of an open capsulectomy and implant removal followed by a possible re-augmentation. If you have been happy with saline implants you can stay with that type of an implant or if you had experienced rippling prior to your development of capsular contractures, then you should consider a round smooth silicone gel implant which tends to have less rippling and feel more natural than saline implants.

Christopher Pannucci, MD, MS · Answer

Hi 2perky,
Implants with capsular contracture often sit high on the chest, and look like a ball. This is because as the scar layer around the implant contracts, the implant takes on the lowest surface-area-to-volume ratio, which is a sphere.
Pregnancy and breastfeeding often stretch out the skin, and you may notice that your breast looks more vertically oval when the breastfeeding volume is lost, and if the excess skin remains--this is because the excess skin and stretched out breast tissue may "fall off" the end of the implant. I don't think pregnancy/breastfeeding will improve the situation, and may make it worse.
If you are trying, then there's not a role for revision right now...but when you are done having kids and breastfeeding, you might choose to meet with a plastic surgeon to discuss revision.
Hope this helps.
Best,Christopher Pannucci MD MSBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Daniel Barrett, MD · Answer

Dear 2perky,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

If the appearance change in the breasts is due to capsular contracture it is unlikely that pregnancy or breastfeeding will help them to look more natural.  I encourage you to return to your surgeon for an evaluation.  Treatments can be discussed based on the severity of your contracture.  I've included a video I hope you find helpful.

Connie Hiers, MD, FACS · Answer

If you have capsules, this will keep your implants sitting a little high and pregnancy will not change this.  Pregnancy may change your breast tissue, but not implants.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!There does not appear to be any evidence to suggest that pregnancy / breastfeeding will improve the status of a capsular contracture. Visit your board certified plastic surgeon 6 months breastfeeding cessation for definitive treatment if the capsular contractures distort breast appearance.Best wishes...

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  Based on your description of a visible change in the appearance of your breasts due to capsular contracture you most likely have at least a grade 3 capsular contracture.  Increasing breast size through pregnancy and breast-feeding unfortunately will not alter the firmness and change in position of your breast implants.  Consult your plastic surgeon for advice and perhaps a trial of Singulair.

Breast Augmentation too perky! Will they look more natural after pregnancy/breastfeeding?

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