Has anyone dealt with grade 3 CC in both breasts within 5 months of surgery with no other complications?

5 months after my breast augmentation I developed grade 3 CC in both breasts. The implants were textured, placed behind the muscle and I healed really well with no infections. The surgeon is now going to replace the implants and place them over the muscle instead, which normally a higher risk of CC with this placement! Has anyone seen this before, what was done to rectify it and did CC develop again after? Also keen to gain thoughts on my surgeons decision to move the placement of my implants.

Doctor Answers 3

Capsular Contracture

Hello,

Please visit a few other surgeons.  Changing pockets is an old fashion technique, and as you pointed out, makes no sense when you have a higher risk of recurrence over the muscle. This was done in a time when we didn't know about bacteria/biofilm causing chronic irritation, which ultimately leads to CC.

You did not mention where your incision is, but periareolar incisions lead to CC three times more than inframammary incisions. Regardless, your revision surgery should be through an inframammary approach. 

The surgery that will lead to the lowest recurrence is either a total en bloc capsulectomy with new implant replacement, or a subtotal capsulectomy using acellular dermal matrix (ADM) like Strattice with new implant replacement. My preference is the former, because in my hands no drain is necessary. It is technically more difficult however, and sometimes the entire scar capsule cannot be removed in one piece with the implant still inside (en bloc). The latter is easier, but requires a drain for the ADM to adhere to the pocket wall, something I try to avoid due to increased risk of recontamination of the implant via the drain site. 

Please visit a few ABPS certified/ASAPS member surgeons expert in revision surgery.

Best of luck!


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

What to do for early contractures?

Its very rare to have what problem you describe.  If your breasts are just firm and now distorted, I would do nothing until changes happened.  Textured implants are firmer and not supposed to move, similar to what contractures may feel like.  When you say grade 3, you should appreciate distortion... so is it present?  If it is, now it gets trickier... as you are truly at higher risk for getting this again.  Consider throwing everything at it and if it fails again, then consider simply having them removed.  This would include new textured shaped implants over the muscle with capsulectomy or use of ADM to wrap your new implants (smooth preferable) placed in a neopocket under the muscle.  But if you have no distortion and just firm breasts, I would do nothing.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Capsular contracture

Capsules can occur with either placement and with smooth or textured implants and are thought to result from bacteria on the implant surface. If you have caspules now there is no guarantee you will not form new capsules.

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