Do I need revision surgery? I have uneven breasts after 9 months. (photos)

I had a breast augmentation 8/14/15, 300 cc submuscular saline implants. The last check up I had was in November (3 months post op) and the surgeon mentioned my right breast was harder so I should massage it -- which I have been doing. It has been 9 months now and they are more uneven. The left breast is perfect in shape and feel but the right is higher and harder. Do I need a revision surgery? Do I have capsular contracture? How much does it usually cost to repair? Thank you.

Doctor Answers 8

Capsular Contracture Not Fixed By Massage

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Your surgeon's recommendation of massage has been shown time and again to not be effective in the treatment or prevention of capsular contracture.  Given the fact that it is hard and higher, it is likely bacterial biofilm, a common problem associated with CC of implants delivered though a periareolar incision. 

You will need a surgery that will fix this problem with the least risk of recurrence. This will require a surgery through an inframammary incision to remove the entire scar capsule and implant in one piece. This is a complex surgery, and I recommend you visit a few ABPS certified/ASAPS member surgeons that perform revision breast surgery regularly. 

Best of luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews


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Thank you for the question and from your descrption it sounds like you do have capsular contracture and would benefit from a revision.  So see your surgeon or other expert in the area.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Do I need revision surgery? I have uneven breasts after 9 months.

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It appears that you do have the classic signs of capsule contracture and at this stage it is unlikely to reverse. Appropriate treatment at this stage would probably include capsulectomy and exchange of your old implant for new sterile implant. Capsule contractures occur most commonly related to either bleeding in the early healing phase while the capsule is being formed or subsequent reaction to bacteria from your breast docs and skin. All surgeons see a small but definite incidence of capsule contracture regardless of who performs the procedure.Meet with your doctor and discuss the cost with him. In my office I do not charge a surgeon's fee if it occurs in the first 18 months but the patient is responsible for costs including the price of a new implant, anesthesia and operating room.

Please watch the video above with some additional information. Good luck to you and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 32 reviews

Early capsular contracture

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Hello and thank you for your question.  Your pictures and description seem to go along with an early capsular contracture.  Unfortunately, the only treatment for this problem is surgery.  Contractures early like this can frequently be associated with biofilm infection so it is important to test the capsule during your revision surgery.  Cost of procedure depends on what exactly you have done.  For the lowest rate of recurrence, I would recommend complete capsulectomy, testing of the capsule for bacteria, use of ADM (acellular dermal matrix), transition to IMF incision, and possibly changing to a textured implant if you are thinking of changing both.  This is a difficult problem and it is very important to seek out a surgeon with significant experience dealing with this complication. I'm so sorry you are dealing with this.

Kelly Killeen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Capsular contracture

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While it's hard to say for sure with only photos over the internet, it does appear that you have right sided capsular contracture.  Revision surgery is likely indicated and this can certainly be addressed.  I recommend followup with your plastic surgeon who will likely want to help you improve your situation, but a second opinion is another option.  This is not a common issue, but one that certainly happens and is definitely addressable.

Best wishes, 
Dr. L

Do I need revision surgery? I have uneven breasts after 9 months.

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Thank you for your question.  The fact that your right breast is harder and higher is indicative of capsular contracture.  This can be addressed with revision surgery.  Be sure to contact your plastic surgeon.  Good luck.

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Will need a revision

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At nine months, I doubt that right implant is going to drop to match the left. This is either early capsular contracture or an implant that never gained access to the bottom of the pocket made for it. A partial removal of the bottom portion of the capsule is usually necessary to allow the implant to create some gravitational descent to best match the left. Cost for these procedures are so variable from physician to physician, location, pre-surgical office policies, location of procedure, and type of anesthesia. I would recommend that you do the most definitive operation to get it right. Good luck with your revision.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Most likely

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You most likely have CC or a high riding breast implant on the right side after breast augmentation surgery.  At this point go and see your surgeon.  If it is a high riding implant (most likely), a simple release of the lower capsule will even out your breasts.  This procedure can be performed without general anesthesia.
Best Wishes,
Nana Mizuguchi, MD

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 55 reviews

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.