Is this capsular contracture? My implants are about 22 years old. Should I be worried? (Photo)

Question

Hi, I have breast implants which are about 22 years old. My left breast has been hurting on and off for about a year, recently I’ve noticed it’s harder and bigger than the right breast. It seems to sit higher that the other breast. My doctor is sending me for a mammogram. Should I be worried?

Jeffrey M. Darrow, MD · Answer

Your descriptions of a hardening of your breast, a shifting of your breast superiorly and some discomfort, are very common with development of capsular contracture.  Your doctor is being prudent having you get a mammogram to evaluate your breast tissue.  If your mammogram is normal, you should have a discussion with your plastic surgeon about your options to correct your concern.

Daniel Barrett, MD · Answer

Dear Annabelle4546,

capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

Capsular contracture is a progressive process. It is the gradual hardening and distortion of the implant as sequential layers of capsular scar tissue are laid down.

It can take several years to develop. Most begin with a change in palpable softness eventually changing in appearance and finally becoming painful/uncomfortable.

It is treated by capsulectomy (removal of the offending scar tissue). However, patients should be aware that recurrence rates are high.

Based upon your story, my suspicion for capsular contracture is high. It is always warranted to begin with imaging (Mammo/US). Assuming imaging is negative, I would recommend seeking out consultation with  your surgeon.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. The symptoms that you describe are most likely secondary to capsular contracture, but other causes need to be ruled out. You should undergo assessment in a breast clinic (typically called a one-stop clinic in the UK) where you will have a physical examination, imaging, and biopsies if they are required. You should have some imaging that will specifically assess the integrity of the implant, for example an ultrasound scan or MRI. It is most likely that this is related to your implant and is not likely to impact your overall health - once other problems have been ruled out then you should consider consulting a plastic surgeon with an interest in aesthetic breast surgery.

Luis Suarez, MD · Answer

The body naturally forms a capsule around any foreign object, including implants, it can lead to excessive tightening. While capsular contracture is not fully understood, the solution is to change the implant in order to relive the pain and discomfort, although it doesn’t guarantee this happen again, it will give you the alleviation you need. Hopefully this helps!

Ira H. Rex III, MD · Answer

Without and exam, I cannot assess whether this is capsular contracture or not.  Some of the findings and symptoms certainly are associated with capsular contracture.  You probably should not be worried.  Lifetime risk of capsular contracture is fairly high, but the problem can usually be fixed with surgery.

Richard Baxter, MD · Answer

If your breast is feeling more firm and the shape is changing, it might be a contracture. A mammogram is good for evaluating the breast but not so good for looking at the implants. I would recommend an ultrasound to see if there is an implant rupture (assuming they are silicone) or a seroma.

Gerald Minniti, MD, FACS · Answer

Mammograms are not for any diagnostic purposes with regards to implants. If they are saline, they are still intact. If they are silicone gel filled, then high resolution ultrasound or MRI. As for your tender left breast, it is likely capsular contracture. This can be fixed with a surgery to remove the scar and implant, and replace with a new implant.

Azita Madjidi, MD, MS, FACS · Answer

Your implant on the left may be ruptured and causing capsular contracture. Mammogram will show your breast tissue , not the integrity of the implant. You need to see a board certified plastic surgeon with all of the information you might have on your implants ( brand, size, style, etc) so you can talk about your options of removing the implants with or without replacing them.

Zamir Paez, MD · Answer

Thank you for sharing your concerns. After 22 years, it’s not uncommon for breast implants to be associated with changes in the surrounding tissues. The symptoms you describe&mdash;intermittent pain, hardness, and differences in size or position between the breasts&mdash;could be signs of capsular contracture. This occurs when the scar tissue around the implant tightens, affecting the breast’s shape and feel.It’s reassuring that your doctor has scheduled a mammogram, as imaging studies are crucial to understanding the situation. Depending on the findings, an MRI might also be recommended for a more detailed assessment of the implant and surrounding tissue.While these symptoms can be concerning, they don’t always indicate a serious issue. However, given the age of your implants, it’s a good idea to consult with a board-certified plastic surgeon. They can thoroughly evaluate your implants and advise if any intervention is necessary. Staying informed and proactive is the best way to ensure your health and peace of mind.

Is this capsular contracture? My implants are about 22 years old. Should I be worried? (Photo)

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