How long do I have to wait for revision or explant? (Photo)

I had an augmentation 500cc under 4 months ago and was recovering beautifully until two weeks ago when my right implant started to migrate up and become sensitive. I visited my PS within days of the onset. He told me to start wearing a band and wait two months. I visited him the next week when the pain from the implant started waking me at night. My right breast is not improving and I'm considering an explant. How long do I need to wait to have a revision or explant?

Doctor Answers 6

How Long to Wait for Revision?

If your recovery up to this point went smoothly, and then there was a new onset change that you describe on the right side, the most likely cause is capsular contracture. An increase in firmness, pain, and upward migration of the implant are all consistent with the development of capsular contracture. Wearing a band, massage, or other treatments such as ultrasound are almost universally not effective, so there is little to be gained by waiting several months.



The treatment requires additional surgery. Typically this would include removal of the implant and excision of the capsule followed by replacement with a new implant. Despite this relatively aggressive approach there is still a risk of recurrence. Lesser procedures which sound appealing are associated with even higher rates of recurrence. Please also keep in mind that certain incisions such as periareolar (nipple area) are know to have higher rates of capsular contracture. 

Capsular contracture most likely cause of change after early good result

From your description, capsular contracture is the most likely cause of the problems you are experiencing. A strap will not help, nor will massage. If you do have CC then you will likely need to have the implant exchanged along with capsulectomy. There is no reason to wait if that is the issue. Good news is that if your implants are Sientra or Allergan, there should be a warranty in place that would cover the cost of the new implant.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 47 reviews

Breast Asymmetry

Hello,

It appears you have capsular contracture, the most common complication of breast augmentation. The use of periareolar incisions puts women at highest risk for this problem. If your doctor is not a ABPS certified/ASAPS member surgeon who specializes in revision breast surgery, you may want to consult with a few.  You will need a surgery through an inframammary incision that removes all of your scar tissue in one piece, so that a new implant can be placed. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

No specific "standard" time for revisionary breast surgery...

I'm sorry to hear about the complication you are experiencing; your description and pictures are most consistent with encapsulation and secondary breast implant displacement. There is no specific waiting time; you should be able to return to the operating room at any point, especially given your significant symptoms. Capsulectomy and re augmentation  will likely be necessary to improve your outcome ( unless you choose to undergo breast implant removal surgery).   Best wishes for an outcome that you will be very pleased with.

Treating capsular contracture

Hi and thank you for the question. Based on your history and the photo it looks like you have capsular contracture. The scar tissue around the implant has thickened and is squeezing the implant which is why it is moving up on your chest and causing pain. You don't have to wait. You can go back to the operating room any time to fix this. The treatment is removal of the scar tissue (capsulectomy) and putting in a new implant. Waiting isn't going to make it better. Good luck to you. 

Dr West

Justin West, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 25 reviews

Early capsular contracture

It appears that your body is developing extensive scar tissue around the implant, so called capsular contracture. Please meet with your surgeon to discuss. Most people need surgery for this.

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.