3 Weeks PO from Breast Augmenation, Concerned I Have CC in One Breast

I had been doing my massages as instructed,taking Vitamin E & had went back 2 1/2 weeks later. When massaging I notice 1 breast doesnt move as well as the other. My PS informed me the scar tissue was forming & performed a closed capsulotomy. Went back 2 days later & was told I may have fluid which contributes to the scar tissue build up. Was told to come back a week later or sooner if swollen. The breast looks diff & I feel tightening when breathing. What's next & how long before a re-do?

Doctor Answers 7

Follow all post op instructions.

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Keep the good communication with your surgeon and follow up with all of the post operative massages you are told to do.  Give it a little more time.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Tightness of one implant

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You are doing the correct thing by following closely with your surgeon. Only time will tell if you need revision surgery but it is a bit early to consider that.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Treatment options for capsular contracture (scar formation) after breast augmentation

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I would recommend doing the following to reverse the changes of capsular contracture:

  • Following up with your physician to make sure that there is no bleeding, fluid collection or infection
  • Frequent and regular massaging
  • Taking Vitamin E
  • Taking Accolate (a small pill used for treatment of asthma) twice a day

if the above does not work, you can have revision and open capsulectomy (removal of capsule).

Please be patient. Closed capsulotomy can injure the implant and usually does no do anything long term.

Best wishes.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Early capsular contracture can sometimes be corrected non-surgically.

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When capsular contracture is caught early, sometimes it is possible to treat it non-surgically.  Accolate is an asthma medication that has been has an off-label indication for halting and sometimes even reversing the changes associated with capsular contracture. Implant massage is helpful, though by itself it may not be totally effective. Although aggressive massage can help to break up scar tissue, closed capsulotomy can actually damage your implant and perhaps increase the liklihood of rupture. Should all of these therapies fail, you may require open capsulectomy.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 23 reviews

You probably have an early capsular contracture

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As others have alluded, closed capsulotomies generally aren't recommended, particularly so soon after surgery, as they may promote bleeding, and somewhat paradoxically, worse capsule formation in the future. If your surgeon thinks you have fluid around your implant, it may be prudent to drain it; blood around an implant is particularly prone to developing into a capsular contracture.

If the swelling continues to improve, your best bet is to wait a few weeks before having repeat surgery (open capsulectomy). It's best to let the acute inflammatory process subside before jumping into your next operation.

Hope this helps. Best of luck.

You have early capsular contracture

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You have tubular breast over the left side and also you have too big an implant. The close capsulotomy is an old treatment that has 100% failure rate and also may compromise your implant. The comment about the fluid collection also concerns me and I wonder what is the fluid.

You best option is to wait and continue with the message and oral Vitamin E.

I would wait at least 3 months before revision if fluid collection is not infection or blood.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Closed Capsulotomy NOT Recommended

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I am actually suprised to read that you had a closed capsulotomy, or any sort of procedure so early after you augmentation.  As a society, plastic surgeons and the implant manufacturers have agreed that closed capsulotomies at any time are not a good idea.  They often cause bleeding as the scar tissue tears, which then can result in the build-up of even more scar tissue over time.  Also, the force that is necessary to really break the scar capsule is usually extremely strong, possibly damaging the implant.  At this point, I would just keep massaging, and possibly as your doctor about starting singulair or accolate.  At the three month mark, if you have not improved, then you may need a surgical revision on that breast.  I hope this helps.

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.