CC and smoking: I have a history of smoking and of capsular contracture in two prior surgeries.

Hello,Capsular contracture and recurrent capsular contracture is a bacterial problem. If your surgeon isn't a revision breast expert who adheres to the 14 point plan and either a total en bloc capsulectomy or a total capsulectomy with a dermal matrix, then smoking cessation won't help.  Best of luck!

Dear jlynnallen,Capsular contracture affects people approximately one in 20.  No one knows exactly what causes it and what can prevent it completely. It's important for your doctor to use a minimal incision and a Keller funnel as a sleeve to protect the implant from touching anything before goes into the breast pocket.  Singulair has been shown to prevent it Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

as its simply not healthy for you.  As for whether it contributes to contractures, its all speculation as there is no scientific proof.  But since you've had a recurrence, your surgeon must be doing everything possible to help prevent this from recurring again and there are several well accepted steps in helping prevent contractures as mentioned by Dr. Minniti.  If you keep getting contractures despite doing everything possible, you have to consider going without implants and consider other ways of enhancement such as fat grafting if you have enough fat to do so.

Smoking and plastic surgery do not go well. The problem is after you have had a contracture you are at risk for repeated contractures and the rates are higher with smoking. One idea may be to have the implants removed and the capsules and do not put any back in for several months. Give your body the chance to clear out whatever is causing the problem Then if and only if you can quit smoking completely have them replaced or I am afraid you will deal with this for the rest of your life. This is round 3, stop doing the same thing over and over and expecting a different result. That is the definition of insanity. You need to do something different and it starts with stopping smoking for good. 

Your risk of recurrent capsular contracture is much higher than normal since you smoke and you have already had capsular contracture twice. You may want to consider having your implants and capsules removed, stop smoking, heal for 3-6 months, then undergo revision breast augmentation. If you undergo a single stage surgery, you will probably develop capsular contracture again.