Doctor thinks I have capsule forming at 3 weeks post op! He prescribed an antibiotic and singulair? Will this even work? (Photos

My right side is harder and less stretched and full and bouncy compared to left. My left had a hematoma and now my right is giving my problems. It's not hard as a rock just more hard!

Doctor Answers 3

Dealing with mild forms of capsular contracture

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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 3 weeks is too early for formation of a complete capsule, capsular contracture can start early when there is significant bleeding, hematoma, or infection or another co-existing problem. This may be the case in your situation.

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.

What you also need to know is that the literature review by Dr. Chong & Dr. Deva titled Understanding the Etiology and Prevention of Capsular Contracture, supports that the risk of capsular contracture is related to implant contamination, and bacterial films.

Since hematoma increases the risk of bacterial infections, and since infections increase the risk of capsular contracture, you need the antibiotics.

In terms of singulair, it works to prevent immune signals leading to inflammation and there have been very few studies applying singulair to CC, but all have shown that singulair is helpful for mild CC (i.e., less than Baker Level 3).

If the situation gets worse, then you will need a capsulectomy (removal of the capsule and implant).

Hope this helps

Toronto Plastic Surgeon
4.9 out of 5 stars 518 reviews


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Three weeks might be a bit early in determining if you have a capsule. You still have swelling from surgery. However, antibiotics and Singulair are used to help treat early capsules.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.8 out of 5 stars 18 reviews

Doctor thinks I have capsule forming at 3 weeks post op! He prescribed an antibiotic and singulair? Will this even work?

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Thank you for your question and photograph.  It would be very unusual to develop a capsular contracture in 3 weeks.  However it is very important to follow the advice of your plastic surgeon who estimated with your case.  Singulair has been shown to reduce recurrence of capsular contracture following revision with saline implants in a study done in England.  It is very common to use this medication when concerned about capsular contraction.

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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.