Breast Augmentation/Capsular Contracture?

I’ve had 2 augmentations so far, both resulting in CC. My surgeon wants to try textured Silicone implants. He thinks I should give this a 3rd try. Is there a real possibility that the 3rd time could work for me? Or should I just cut my losses and get this one last surgery, remove implants, and call it a day? I am leaning towards removal. Sorry this is short. This site only allows a small amount of characters.

Doctor Answers 9

Breast Implant Capsular Contracture Best Treated With Alloderm or Strattice

Thank you for your question.currently the recommended S treatment for recurrent capsular contraction around breast implants is the following:

1. Removal of breast implants

2. Removal of the capsule

3. Replacement with textured breast implants

4. Wrapping of the implant with acellular dermal substitute such as AlloDerm or Strattice

Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery and fillet with the use of dermal substitutes.

Recurrent Capsular Contracture

Patients who have recurrent capsular contracture understandably can be extremely frustrated by their situation and sometimes feel like giving up on implants. Taking implants out and leaving them out is always an option and I would consider this the final pathway for patients who have tried all other options and continue to have issues with their implants. In general, there are a number of things that can be done to reduce the risk of recurrent capsular contracture. First of all, if a patient has implants in the subglandular plane (on top of the muscle) I would switch them to a submuscular plane as this lowers capsular contracture risks. Secondly, I would perform complete capsulectomies to remove all the old scar tissue and remove the old implant presuming there may be a biofilm that is creating an inflammation within the capsular contracture. Thirdly, for patients with recurrent capsular contracture I generally recommend using Strattice, which is an acellular dermal matrix, which can dramatically lower the risk of recurrent capsular contracture. This is not 100% foolproof, however the rate of capsular contracture with this material tends to be less than 1% and I have had great success in taking care of patients who have had recurrent problems with capsular contracture. Lastly, I would try to avoid dissection through the areola or onset area to minimize risk of contamination with placement of the new implant and I would recommend going to under the breast incision if possible. Make sure that your surgeon understands all the different options for repairing capsular contracture and if these are not discussed you may want to consider getting a second opinion from a Board Certified Plastic Surgeon who takes care of revision in complicated breast issues on a regular basis.

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 53 reviews

Recurrent Capsular Contracture

I have had very good results with Strattice in the treatment of recurrent capsular contracture.  I would speak with a surgeon familiar with its use.  I would recommend a large, Contour 3 piece, inserted immediately following capsulectomy and implant exchange.  In my experience, a textured surface implant exchange is much less predictable in prevention, and has other potential drawbacks.

Paul H. Rhee, MD, FACS
Castle Rock Plastic Surgeon
5.0 out of 5 stars 28 reviews

Capsular contracture, firmness and breast options

capsular contracture,  firmness and breast options

there are several options..   a form stable anatomic implant by sientra,

fat injections only for a natural breast augmenttion... works well if you have some fat


belladerm lattice etc   can be added but its expensive


Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Recurrent capsular contracture

I would like to have the details of the first post-op course and the second operation itself. If you had bruising after your first surgery, for example, this was likely the cause of the contracture. And if a capsulotomy (capsule not removed) was next performed, there is good reason to think you may have success with a capsulectomy (removing the capsule) and possibly placing new implants. If the contractures were on both sides, both times--much more likely to have continued problems. Best of luck.

Andrew Stewart, MD
Charleston Plastic Surgeon
3.8 out of 5 stars 8 reviews

Strattice for capsular contracture

There are several issues to consider when you have recurrent capsular contracture. The main thing is to try something that has not been done previously, and going to textured implants might help but I think something more definitive should be considered. Another factor is that each time the scar capsule is removed there is loss of coverage and support for the implant. A Strattice graft has a very high probability of preventing the contracture in my experience and it also helps support the implant like an internal bra.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Capsular Contracture

Sorry to hear that you are having trouble with capsular contracture.  It sounds like removing the implants and the capsule did not solve the problem during your second surgery.  In this case, I would suggest a different approach such as using an acellular dermis product such as Alloderm or Strattice to help prevent the capsule from forming.  There are also some oral medications which you can take which may be helpful during the healing process.  


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

With repeated recurrences of capsular contracture, I'd try a more aggressive approach.

Capsular contracture has a high risk of recurrence.  When I see a case such as yours, I try to do everything I can to minimize the risk.  We have many different things that can decrease the risk of a repeat contracture.  They include complete removal of scar tissue, changing the location of the implant (for example from a location above to below the muscle), placing acellular dermal matrix such as Strattice, postoperative leukotriene antagonists such as Singulair or Accolate and textured implants.  In all cases I have used all of these methods, there has been improvement.  Sometimes despite all of this, contracture can recurr, but it is always better than before.  I would seek a surgeon that could offer these approaches to you if you wish to keep your implants.  If not, removal of implants and the surrouding scar tissue would be the other option.


Shim Ching, MD
Honolulu Plastic Surgeon
4.6 out of 5 stars 48 reviews

Redo breast augmentation

Unfortunately it is difficult for me to answer this without an exam.  There are different approaches for this problem including removing all implant and capsules and redoing them 3-6 months later, as well as adding strattice with new implants after implant exchange and capsulectomy.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.