Signs of Capsular Contracture?

I had submuscular silicone implants put in 1 year ago.My right breast looks and feels great, my left one seems to have start looking like it sticks out further and on the bottom inner area it feels & looks hard and more straight than rounded. It also hurts a lot around the same time as my monthly cycle. Overall the left one feels harder all over than my right. I massage them daily. Its been going on for a few months so not sure what I should do or if this is signs of Capsular Contracture?

Doctor Answers 17

Capsular contracture signs

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Capsular contracture is when there is abnormal scarring around your implant, tightening it and causing the breast to feel firm. The breast may also look abnormally round or elevated. This can sometimes be treated without surgery, but if the problem persists, you may need surgery. I recommend you go back to your surgeon to have your breast checked out as soon as you can. Best of luck.

Hardness after a breast augmentation.

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Capsular contracture typically presents as a progressive tightness, firmness, and elevation of a breast implant. In severe cases, it can lead to intermittent or constant pain. From your description you may be developing a capsular contracture of the left breast. What to do? Call your plastic surgeon and schedule an appointment to be seen. Conservative methods such as massage can help in mild to moderate cases. Surgery is necessary for correction if conservative methods fail. Surgery consists of capsule excision with or without the use of a dermal matrix (Strattice).

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Hardness after aug

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This is the big question,why one breast is soft and the other hard.It can happen.soem patients may respond to massage or some singular which is a tablet.Sometimes an open capsulectomy is needed.

Capsular contracture?

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This certainly sounds like you have a textbook definition of capsular contracture. At this time, size or any other remedy will have no effect on this process. The only remedy is surgical, and even after this is performed there is no guarantee that it might not reoccur. You should speak to your surgeon and address these issues if you are uncomfortable. Unfortunately, most of the time this is a progressive problem and will not get better.

Treatment options for breast hardening

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From what you are describing with increased firmness and possibly tenderness to your one breast may indeed be the early signs of capssular contracture. While it is still not known why this begins to occur, there are a few theories of what causes this inflammation of the capsular lining around the breast. Thus available treatments are geared towards decreasing the inflammtion. Oral drug therapy has been found effective in only a small amount of patients wheen started early (Singulaar or Accolate) and are directed at the inflammatory cascade. Message and vitamine E are things you can try, but are usually not successful at rversing the process. Mild ultrasonic treatment of the breast capsule (known as the Aspen Process) has been showing some encourging results and woud be your other option short of revisional surgery.

Terry Zimmerman, MD
Folsom Plastic Surgeon

Signs of Capsular Contracture

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#Capsular #Contracture is a common condition in which the capsule around the implant thickens and squeezes the implant making it hard and often changing the shape and position of the implant. It is more common in nicotine users (e.g. smoking or nicotine patches or gum). Effective treatment of the capsule frequently involves completely removal of the capsule (capsulectomy), and occasional incisions in the capsule may be somewhat helpful (#capsulotomy). 

Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant.

Saline implants may deflate spontaneously. When the patient has significant #symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is recommended to ensure adequate pocket dimensions.

New implants may then be placed in the same existing position or may undergo a change of #placement frequently from submammary to subpectoral position and, on occasion, the other way around.

Follow up with your operating surgeon

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Thank you for your question.  I think that it is important for any patient who has a concern about a cosmetic procedure that they have had continues seeing their operating surgeon for routine follow up care.  This is no exception.  What you are experiencing may be indicative of a capsular contracture or it may be something else entirely.  Schedule a follow up visit with your operating surgeon to discuss your concerns and for a physical evaluation.  Best of luck!

Possible capsular contracture

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Unfortunately, it does sound like you have developed a capsular contracture.  If mild, they can be left alone.  The more severe the degree of hardness, the more misshapen the breast will become often becoming more projected outward, rounder, and displaced higher on the chest compared with the softer breast.  They can also become painful.  The only truly effective treatment is surgery to remove the capsule scar tissue and replace the implant.  All other treatments have not been shown to be effective except in rare instances.  I would make an appointment to see your surgeon to seek his input.

Signs of capsular contracture

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Unfortunately it sounds like you might be developing capsular contracture.  I would recommend that you make an appointment and see your plastic surgeon.  You will probably require capsule removal and replacement of your implant.

Breast Implants and Capsular Contracture

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I think you are correct in your assumption:  gradual hardening of the breast implant, a change in position of the breast implant, and a change in shape of the breast implant are all classic signs of breast implant capsular contracture.  

There is nothing that you could have done or should have done to prevent this from happening.  Unfortunately, at this point there is nothing you can do to slow or stop the progression of capsular contracture either.

You may feel comforted to know that capsular contracture following breast implant placement can be corrected, however, this will require an additional surgery with removal of the excessive scar tissue, possible change in pocket of the breast implant (i.e. moving the breast implant from over the muscle to under the muscle, or vice versa), and possible replacement of the implant.

Make an appointment to see your plastic surgeon in order to discuss your options for correction.

Jaime Perez, M.D.

Breast Implant Specialist in Tampa, Florida

Plastic Surgery Center of Tampa, Florida

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.