Does a capsular contracture require treatment or can you live with it?

A capsular contracture is your natural response to something foreign in your body.  I think the prevailing philosophy is that it may result from bacteria which is why it is a bigger problem with implants are on top of the muscle (where bacteria live) rather than under the muscle.  The capsule itself is not dangerous.  It is more of a nuisance due to discomfort, firmness, or distortion of the breast.  If you are not having any of these symptoms then it is not a problem to leave it alone for now.

Non-surgical management of capsular contracture includes prophylactic massage to prevent it and if it occurs, the use of certain anti-asthma medications: Singulair and sometimes Acculate as off-label FDA usage to treat Capsular Contracture and in some cases of recurrence of capsular contracture in a preventative fashion. In my experience this works best for early diagnosed early contractures and used as a prophylactic, perioperatively when doing a capsular contracture surgery. The price for capsular contracture surgery varies greatly by geographical location, experience of the surgeon, whether in an outpatient surgery center vs hospital (hospital more expensive), type of breast implant, whether it is ruptured or not, estimated length of operating room time, and other factors.

Thank you for your question, and I am sorry to hear of your CC issues.  You can absolutely "live with it" if the CC is not causing you any significant issues - pain, implant deformity, implant malposition, etc.  I would let your surgeon know so that you can discuss future treatment options when your financial and family situation changes.  Hope this helps.

I appreciate your question.There are varying grades of capsular contracture:Grade I —
the breast is normally soft and appears natural in size and shape

Grade II
— the breast is a little firm, but appears normal

Grade III
— the breast is firm and appears abnormal

Grade IV
— the breast is hard, painful to the touch, and appears abnormal

From your description, it sounds like you have grade II.  This can possibly be treated with medical management.  Discuss with your surgeon as since you are planning to become pregnant might be best to wait.

The best way to assess and give
true advice would be an in-person exam.

Please see a board-certified
plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!



Dr. Schwartz

 You ask a very intelligent question.  You also answer it very intelligently yourself.There is no danger in living with a capsular contracture.  Many women do just that.  A contracture that is not painful and not causing distortion of the breast is something that many women choose to "live with".  You are also correct that there is no guarantee that it won't recur after more surgery.  If it becomes more of a problem, you can always change your mind and have it treated in the future.Thanks for your question.  Good luck with the next pregnancy.

Thanks for your question. Your thought process is very logical and exactly correct. If you have no pain and your breast shape is "not bad" there is no reason that surgery should be performed. As you probably know there are varying degrees of CC. It seems that you are in the grade II category. Many woman live with this level of CC for a long time. Best of luck!

If you are ok with the pain and distorted shape of the breast that has capsular contracture then yes, live with it. There are non-surgical options for treating, but most only work when caught early and you said you've had this for three years. I'm sorry that you are experiencing this, but no harm should come from leaving it alone. Best, Dr. Nazarian

Thank you for your question.  Firmness in the breasts, as well as some asymmetry (one breast "settling" before the other) is very common right after breast augmentation.  Augmented breasts (and non-augmented breasts) also change in very unpredictable ways after pregnancy and breastfeeding.Massage may help your contracture.  You might also talk to a board-certified plastic surgeon about trying a particular medication that can be used off-label to help with contracture, if the surgeon you see thinks it might be helpful.To answer your specific question, though, NO, you don't have to do anything about this contracture.  If it worsens to the point of pain or malposition, then you would need to do something about it.I've included a link with some before/after photos of breast implant revisions, some of which were for capsular contracture. They might give you some idea of what to expect or look for.Best wishes,Dr. K

Having had a capsular contracture or two myself, I get it.  Even if they don't deform the breast they are just annoying.  First, you do not need to have it treated now or ever,  it is no threat to your health or your implant.  Second, if another pregnancy is imminent I would for sure wait until after because, as you know, pregnancy changes the breast .  I wouldn't dwell on when the capsular contracture was diagnosed, because early on a stiff swollen breast feels exactly the same as a grade 2 capsule which has what you describe.  I recommend you wait until after pregnancy and breast feeding and then reevaluate your breasts yourself.  If anything bothers you then see a board certified plastic surgeon at that time.  Like I said, I get it, capsules are annoying but there is no rush to do anything.  I hope this helps.