Will putting new implants under the muscle reduce capsular contracture? (Photo)

I got an uplift and cui implants in feb 2014 Over the muscle, I had capsular contrature noticeable by October. My surgeon advised me to change to motiva implants in November 2014 and remove the capsule. I'm now 2 and a half months post op and my right is sitting slightly high and harder so he has prescribed me with an asthma medication that is ment to help, he said if it doesn't I have to halve them removed, both times I have had surgery I have had a slight infection on my right side.

Doctor Answers 5

Concerned about Capsular Contracture

One of the most common problems is breast capsular #contracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer #implant. Nicotine users, such as smokers, have up to a 30x increased risk of #capsular contracture.

Saline implants may deflate spontaneously. When the patient has significant #symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. Capsulotomy or opening of the capsule may be required or frequently capsulectomy, which is removal of the scarred capsule, is recommended to ensure adequate pocket dimensions.

New implants may then be placed in the same existing position or may undergo a change of #placement frequently from submammary to subpectoral position and, on occasion, the other way around.

Orange County Plastic Surgeon
5.0 out of 5 stars 110 reviews

Unclear pics

Please do post better imagines and many perspectives, sides, obliques, with good light. Some concepts to help you:
-such asthma medication is USELESS and has NO scientific foundation as capsular contracture therapy, in fact its hepatotoxicity makes that in many countries its use is restricted to pneumologists-only and its use for other purposes is strictly forbidden, don't take it!!!
-CUI implants are macrotextured, this means prepared against capsular contracture and with low rates for it, however the Motiva are microtextured, this means with higher rate of capsular contractures, makes no sense what you have been suggested
-the fact one implant is high is not necessarily capsular contracture
-polyurethane coated implantes are the indication in recurrent capsular contracture, in subfascial plane of placement, you are a case for this

Do seek the opinion of a very good revisional plastic surgeon with solid experience.

Alejandro Nogueira, MD
Spain Plastic Surgeon
4.9 out of 5 stars 45 reviews

Breast Implant Revision

Thank you for your question about breast implant revision.

Yes, infection and bacteria has been implicated with capsular contracture and sometimes the implants must be removed.

Submuscular pocket placement is often an option.

Note, large implants often have more complications and problems.

Best to follow up directly with your plastic surgeon.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews

Does placing the breast implants under the muscle protect against capsular contracture?

Hello and thank you for your question. With respect to capsular contracture, in general, textured implants recently have been shown to have a slight advantage in protecting against capsular contracture. A submuscular pocket along with several other strategies have been found to be helpful too. Round implants do not have the risk of rotation that anatomic implants hold, but round vs anatomic textured implants are viable options in the right hands. There is a lot that is discussed on this topic throughout RealSelf and online, but in the meantime, you are doing the right thing by keeping in touch with your Plastic Surgeon and be patient as you are only 2.5 months post-op and in the healing phase.  Your surgeon will be best able to assess whether or not you will need another procedure and if this entails performing surgery on only one breast to match the other (in such a situation, they may try to keep the pockets and implant styles matching) vs changing out both (performing extra surgery on an asymptomatic breast to achieve symmetry in both breasts after surgery). Hope this helps and good luck.

Sean Kelishadi, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 27 reviews

Under muscle best for Capsular Contracture

In general under muscle is better to prevent capsular contracture, and if it has been a recurrent problem then consider Strattice as well. Your implants appear on the large side so the extra support from Strattice coiuld also be beneficial.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 53 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.