Thank you for your clinical post and
photo. It certainly does appear that the
right sided implants rides too high and has not dropped into the pocket. Often this is a pocket creation issue and not
early capsular contracture as there is not enough collagenous tissue to induce
contracture at this early phase.
However, aggressive massage is usually the right prescription and this
can be combined with a breast band to keep downward forces on the upper pole of
Short of adequate descent in the
inferior pole of the pocket and one will usually wait 4-6 months to assess
this. You may be looking at a revision
surgery where pocket expansion and facilitative inferior descent to the implant
It sounds as though you have
excellent care with your plastic surgeon.
It was just too early to contemplate a revision. Continue aggressive breast massage, consider
a breast band and hopefully you will get some inferior descent, but there is a
significant probability of enhancement revision surgery with pocket expansion
and inferior descent of the implant.
I hope this information is of some
assistance and best of luck.
R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
It is not uncommon for implants to come down at different rates. You should wait to see if the treatment plan is effective.
The phenomena of capsular contracture cannot occur within the first few months after breast augmentation. Any firmness of the breast at this time is due to swelling within the tissues.The position of the right breast implant is a bit worry some but if the trend is favorable it's best to leave it alone for now.
Thank you for asking about your breast augmentation.'
- One implant always comes down first - frustrating as it is.
- Ask your surgeon if you can go braless - sometimes that helps.
- Generally we wait 3 - 6 months before doing a revision -
- Often it takes that long for an implant to settle.
Always see a Board
Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.
Thank you for your question. I agree that it is still too early to determine if revision surgery is needed however, you should have more symmetry at this point. I suggest that you continue, as directed by your surgeon, to continue with the massage and follow-up at appropriate intervals with him/ her. You may likely need revision surgery and removal of the capsule with implant replacement.
Best of luck,
It is not possible to diagnose capsular contracture without an exam to feel the breasts, but the difference between your picture at 4 days and 8 weeks postop, is characteristic of a capsular contracture, and almost certainly will require a revision and likely at least a partial capsulectomy. There is no way to ellminate the risk of capsular contracture. I would follow along with your surgeon, and after an appropriate interval of several months, be prepared for revisional surgery.
At one month after surgery, it's too early ,in my opinion, to say that a revision will be definitively needed. I would wait at least 3 to 4 months. If you need a release at that time, you may want to go a little bit larger on that right side to better match the left. Follow up with your plastic surgeon recommended. Good luck.
I think you should wait as well but 8 weeks after surgery there should be better symmetry than your photo shows. Unfortunately i don't think that will resolve on its own and a surgical revision may be necessary. Best of luck.
Thank you for your question. You are still early in the post-operative period. It typically takes 3 - 6 months for the swelling to subside and and implants to settle into proper position. Swelling usually accounts for 10 - 15% of the initial post-operative appearance. The implants often settle asymmetrically as in your case, but ultimately end up the same. Please discuss your concerns with your board certified plastic surgeon. Also, make sure you follow all of your plastic surgeons post-operative instructions regarding level of physical activity and use of a support bra. Hope this helps and good luck with your recovery.
I have seen implants settle quit differently and eventually end up very similar. The process takes at least 3-6 months. If you require surgery, it is usually done as a local procedure.
Nana Mizuguchi, MD