i am not sure if i have capsule contraction or bottoming out all i know is i am really unhappy with them. is there anything i can do to have this fixed? my left breast became deflated and had capsular contraction so i had a 2nd operation to replace the deflated breast.i also had also had a doughnut mastoplexy,i currently have high profile saline,540cc left and 520cc on right.i feel the left is smaller and the nipple points upward.also it dosnt moveas freely as the right.
I Believe I Have Capsule Contraction, Can They Be Fixed?
Doctor Answers 4
Left capsular contraction and asymmetry
Without examing you it is difficult to say for sure, but if your left implant is firmer and less movable than the right, then you have a cpasular contracture on that side. Perhaps both inframammary folds were lowered as it looks in your preop photos like you have high, tight folds. If so, then the right side, which looked a little less constricted in the lower pole preop, has rounded out nicely. The left side shows a contour deformity which may be caused by a lower pole that did not round out with release of the old fold, and thus there is a remnant fold which gives you a double contour. I hae also seen this type of lower pole deformity caused by some pectoralis muscle distortion. In any event, you will need some type of revision of that left breast, possibly a new subpectoral pocket with closure of the old one to reposition the implant and treat the capsular contraction if indeed there is one. Obviously, discuss this with your surgeon.
You have pectoralis muscle detachment and implant displacement medially
Your right breast has a good result. The left has more than capsular contracture. The pectoralis muscle origin from the sternum is released and the implant is moved toward the mid line. The bulge you see is the implant and some surgeon call it double bobble. You will need to have muscle and capsule reattachment and capsule release laterally.
It looks like a double bubble.
On your initial preop pictures, it looks as though you have high asymmetric infra mammary folds and some component of lower pole hypoplasia. In the first postop, you have implants that are a little high and uneven. In the last set of pictures, the right looks very good. The implants have obviously been lowered. The issues on the left include: Asymmetry of the nipples, poor lower pole shape with a double bubble and possible volume asymmetry. I cannot tell if you are encapsulated. The fixes are complex but could include excision of tissue on the lower part of the breast to lower the nipple, internal re-shaping to try to decrease the double bubble, and a capsulectomy (with or without Strattice) if you have a recurrent capsule. Ultimately, you need to discuss with your surgeon.
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Revisional breast surgery planning
Without a physical examination, CC cannot be diagnosed, but based on your photos, you appear to have contracture of the left implant. The 'fix' is typically a complete capsulectomy, a replacement of the implant into a submuscular position or neo-submuscular pocket (if implant is already below the muscle)- there is some evidence to suggest the acellular dermal products like Strattice might limit future capsular contracture when used in cases like yours.
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