I was diagnosed with capsular contracture and my surgeon tried to break the scar tissue in the office. Is this recommended?
Doctor Answers 4
With grade 2 contracture, I would simply try aggressive daily breast massage. This may loosen the pocket slightly. If this doesn't work, ultrasound and certain asthma medications like SIngulair may help, although the papers on these approaches are not conclusive.
Ultimately, you may end up having one breast that is firmer than the other, but if they look symmetrical and you do not have any discomfort, it is probably best to avoid surgery. If the contracture progresses to a grade 3 (visible distortion) or beyond, an implant exchange with surgical removal of the capsule and possible placement of Strattice would be the best option. If you choose to increase your size, you will have to operate on both breasts, so often the simplest choice is to correct the problematic side and leave the normal side alone to minimize risks. Good luck!
Breast implants - is a closed capsulotomy recommended
- Your surgeon was trying to do a closed capsulotomy - rupturing the capsule with pressure on the breast.
- It was popular in the early 1980s and some surgeons still do this but the research shows that besides being painful, the capsule returns and often ruptures irregularly, giving the breast an odd shape.
- Capulectomy surgery is not high risk - but it seems you already have large implants for your frame.
- Your surgeon will have to examine you to see if there is an implant that can be used that is larger.
Hope you find this information helpful. Best wishes.
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If you were my patient and you had a Grade 2 contracture, I would place you on Accolate for 90 days and do ultrasound on the breast. This has proven to be successful in the first six months after the formation of a mild capsular contracture.
As for an open capsulectomy (the removal of scar tissue directly), this is the treatment of choice if non-surgical intervention fails. With open capsulectomy, there is always the potential for post operative bleeding and a slightly higher risk of recurrent capsular contracture, especially if non-pathogenic bacteria are the cause of the contracture.
That being said, I very often do open capsulectomies to eliminate capsular contractures, and as an adjunct, I put Seri in to decrease the chance of recurrence.
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