Possible capsular contracture? (Photo)

I am almost 7 weeks from my breast augmentation surgery and my breasts are still sitting high and firm. My doctor confirmed they are very high. My left is higher than the right and I can feel how firm the implant is especially at the bottom. I'm worried I have a capsular contracture in my left because it is so firm and high. Does it look like one and what can I do to prevent it?

Doctor Answers 7

Implant not dropping

Generally speaking, especially early in the post-operative phase of healing, it is not uncommon to have one or both implants appear to be high up by the clavicle. Although the “pocket” may be made correctly, the implant may not have access to the bottom for several reasons. If the overlying muscle or skin is tight, this will move the implant to the path of least resistance which is up and towards the underarm where there is little or no pressure. As the pressure relaxes, the implant will drop down to the bottom. Smooth implants, because their surface is slippery, may move faster downward than a textured implant with its rough surface. Because these variables mentioned above can be different for each side, it's not uncommon that one side will drop faster to the bottom of the pocket than the other. Similarly, sometimes one breast will swell more than the other or be more painful than the other early in the postoperative phase. After the first month or two, usually things will even out. It wouldn't be, in my practice, until four months or so has passed that I would entertain going back to the operating room to “touch up” the location of the breast implant in the pocket. Sometimes specialized bras or straps as well as massage and stretching protocols may be helpful in allowing this process to happen more quickly. Each plastic surgeon will have different thoughts on what the best protocol is for the patient. Your operating plastic surgeon will be your best resource to have this information passed on to you. I recommend that you faithfully follow up and follow the instructions of your chosen plastic surgeon. Congratulations on your surgery, and good luck on an uneventful recovery.

Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Breast implants and capsular contracture

Each breast implant will settle at slightly different rates and typically takes a few months to occur. You are a little early to have capsular contracture but talk to your plastic surgeon about massage, vitamin E and Singulair.Best wishes,Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 reviews

7 weeks post breast augmentation and capsular contracture?

Thank you for your photo's and question.  It is too early in recovery due to implants taking up to 3-4 months to settle in their pockets.  Also, many times,the implants don't settle at the same time , so your left may just be slower than your right to settle, as well.  

Chad Robbins, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 49 reviews


Your implants look nice so far, and the two sides will always be a bit different and have slightly different feels. it can take 4-6 months to settle completely.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Possible capsular contracture?

You are still very early on into your recovery period. It will take several months and even up to a year to see you final result. It is impossible to confirm a capsular contracture through a picture and this would need to be addressed by your surgeon. 

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Capsular Contracture ~ 7 weeks postop?

Thank you for your question.

In general, capsular contracture (CC) can occur at any time, but most cases are documented in under 12 months (i.e., anywhere from 3 months to 12 months post operation). This is because it takes time for the fibrous tissue capsule to form around the implant, and then it will have to scar down (contract).

Although 7 weeks is too early for formation of a complete capsule, capsular contracture can start early when there is significant bleeding or infection or another co-existing problem. If this is not the case, I wouldn’t worry.

Usually, the breasts will feel firm and tight this early after breast augmentation, making you think that it may be capsular contracture. However, such tightness is just because the breast tissue and skin have not adapted to the implants yet. This is evident by your own statement that they are still riding high. With effects of gravity and healing, the breasts will drop and feel more natural and soft as time goes. Once that happens, the implant will sit directly behind the breast tissue in a natural 45:55 breast ratio. Your breasts will achieve final results after 3 to 6 months post-surgery.

It is also not uncommon for breasts to heal and adapt to implants at different rates.

Now I need you to know that there are 4 grades/levels 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.

If your breasts do not appear abnormal, or painful, then you do not require surgery.

In fact, grades 1 and 2 CC do not require surgery, and can be fixed with breast massaging and singulair.

Massaging will keep the naturally occurring capsule stretched hindering it from contracting. However, this should not be done excessively as you may further aggravate the breast pocket causing inflammation.

That being said, you can also help prevent a capsular contracture by having regular follow-ups with your surgeon to make sure your breasts are healing beautifully.

Remember that your surgeon’s instructions should take precedence over everything else you read on here, so before doing anything, ask them.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

Possible capsular contracture?

Thanks so much for your question and photos. At 7 weeks post op you are still not seeing your final result. Typical healing time takes place at approximately 1 year post surgery. Capsular contracture will feel hard, tight and results in breast distortion. Please contact your surgeons office as he/she will be able to follow up and monitor your progress. 

Robert Sleightholm, MD
Brampton Plastic Surgeon
5.0 out of 5 stars 9 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.