Capsular contracture (sp?) - should I get smaller implants?

If your fear is recurrent capsular contracture, then you need to identify root causes. One of them isn't one of them per se: implant size. CC can occur early (within 6 months from surgery) or later. Early reasons include the use of periareolar incisions, implant placement over the muscle, not irrigating with Betadine prior to implant placement, not using an implant deliver funnel, or poor wound healing. Late causes include bacteremia (bacteria in the blood stream from an infection or procedure not prophylaxed with antibiotics), or long term silicone gel implant rupture. Fixing CC should include the use of an inframammary incision, removing and discarding the implant, and removing as much of the scar capsule as possible. A new implant should be used and should be placed in the sub-pectoral position. A drain should also be used, and if so, antibiotics should be given until the drain is removed. Biologic material known as acellular dermal matrix can also be placed at the time of surgery.

Dear tashmommy,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery