I had my original augmentation 10 years ago but because of clots I've had to have them done 3 times. My last surgery was 5 years ago and now I have extreme tenderness and tightening on the right side. I've had blood clots in the past as well as capsular contraction and scar tissue. I'm seeing my plastic surgeon because one is deformed and I want them replaced. Any advice?
I'm Having Severe Pain and Tightness in my Right Implant. My Surgery Was 5 Years Ago?
Doctor Answers 6
Pain and Tightness Signs Of Capsular Contracture
Pain and tightness in your breast can definitely be signs of a capsular contracture. If you have had a capsular contracture in the past, you have increased chances of it occurring again. The first step is making an appointment with your board certified plastic surgeon for an in person examination.
Pain and Tightness in Breast after Implants
Pain and tightness in a breast after the placement of breast implants can indicate capsular contracture. Those patients with previous capsular contracture are at higher risk for recurrence of capsular contracture. Kenneth Hughes, MD breast implants Los Angeles, CA
Capsular contracture after breast augmentation
Scar tissue can form around an implant even years after the surgery, and cause pain and distortion of the breast. There are several theories to account for this and fortunately, it is a fairly rare occurrence. The likelihood of a contracture developing is increased if there is a history of contracture and also if there has been a post operative hematoma. There are several things that can be done to treat this, these include:
1). A trial of Singulair, this is an off label use but has had some success if treatment is started early enough.
2). Reoperation and placement of the implant in a new pocket.
3). Reoperation and using an artificial material to enlarge the pocket, (acellular dermal matrix).
4). I would recommend exchanging the implants under any circumstances.
Which technique is the right one for you will depend on your individual circumstances. Consultation with your board certified plastic surgeon should be your next step.
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Based on your description, I suspect that you may have another capsular contracture. There are several factors that can increase the risk of contracture and you have two- a history of capsular contracture and hematomas.
While there is no way to guarantee that the contracture will not recur after revision surgery, there are newer techniques that may decrease that risk- including the use of Strattice, changing the position of the implant (pocket change), and placement of new implants.
Recurrent capsule formation
What you are describing is most likely recurrence of capsular contracture. Patients who have had capsule formation in the past are more likely to develop contracture again. Also bleeding after surgery increases the risk. Most common recommendation include sub-muscular placement if they are over the muscle. Start vitamin E oral capsules after surgery. Off label use of Singular is showing some promise if capsules are early in formation. Use of acellular dermal matrix may help but is expensive. Use of textured implants is thought to help but I am not sure if this is a real experience or not.
Capsular Contracture and Pain
Based on your description, it appears that you may be suffering from a recurrence in the capsular contracture. There are several treatment options to help prevent recurrences of this condition.
1. Site Change - If your implants have been placed above the muscle, then placing the implants below the pectoralis muscle may help.
2. Textured Implants - The incidence of capsular contracture is lower using textured implants vs. smooth implants when placed above the muscle.
3. Postoperative Drains - Hematomas or "Clots" can contribute to the formation of capsular contracture in primary or revision breast augmentation. The use of drains in the future may help to prevent the formation of your clots, if you decide to undergo surgery again.
3. ADM - Acelluar Dermal Matrix provides an extra barrier to resist the formation of capsular contracture.
4. Singulair - This medication is prescribed by your surgeon and taken daily for at least 3 months to diminish the recurrence of CC.
Good luck and thank you for your question!
Gregory C. Park, M.D.