My right breast feels slightly firmer and sits a bit higher than the left. Early sign of capsular contracture? (Photos)

The short answer is, in my opinion, to do nothing at present but be monitored by your surgeon. Thank you for bringing this technique to my attention because I hadn't heard of it (not approved in the USA) until now, so I did some research on the web. I'm not sure what your surgeon would decide to do but it seems too early to take action. Our present technique of sub-muscular breast implants with Mentor implants provides natural results with highly accurate placement and a quick recovery, and that is what we use routinely to avoid the problems of asymmetry that you have. Sub-muscular placement also has a very low capsular contraction rate. This is what you may eventually need.

Your description suggests the possibility of a capsular contracture. A definitive diagnosis would require a physical examination by your surgeon and a follow up visit would be warranted. If a capsule is identified, your surgeon can discuss options for treatment. These options may include simple observation, surgery or in some cases non-surgical treatment such an taking singular or montelukast.

Even without an in person examination, your photographs seem to show a typical capsular contracture. It is not dangerous to your health, but it may progress to a point that it hurts. For now, you can certainly monitor this. There is not much chance it will improve on its own, but if you find it acceptable to live with, then that is certainly fine. Good luck with things.

If you’ve noticed sudden changes in the shape or feeling of your breast it would be a good idea to see your surgeon for an assessment, just in case.

Dear nal7t36n65leao,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.



Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Capsular contracture refers to abnormal thickening or accumulation of scar around the implant over time. This can thickening the capsule and tighten the pocket. It is a progressive process which initially may go unnoticed followed by subtle changes in firmness which can then progress to visible distortion and eventually pain.

While the rate of capsular contracture, historically, has been quoted as high as 30%, much has changed over the years leading to a precipitous decline in the incidence. These developments include: submuscular placement, the use of 3x antibiotic irrigation, cohesive gels, "no touch" techniques utilizing a funnel device, fold incisions.

The cause of the contracture remains unclear, however, the prevailing opinion is that it is a consequence of irritation/inflammation. Thus measures which reduce potential inflammation have proven effective in reducing the incidence of contracture.

While your narrative is suggestive of early contracture, it is difficult to say without an in-person assessment. Regardless, early treatment is non-operative and may involve options ranging from massage to anti-inflammatory regimen.

As always, discuss your concerns with your board certified plastic surgeon (ABPS).

Yes, it does look like it could be an early capsular contracture, however, if early on post procedurally, the capsule might be corrected with massage (displacement exercises) with the possible addition of medication that can help to attenuate the capsule.

It is very likely that you may be devoting breast contracture. You should discuss options of treatment with your surgeon. Good luck.

Thank you for your thoughtful and detailed question, you’re describing a concern that many patients share, especially within the first 1–2 years after breast augmentation.

Thank you for your question. Based on the photographs only, there does appear to be a mismatch in implant position. Physical examination with your surgeon may be delineate whether there is early capsular contracture, or implant descent on the left. Continuing with implant massage may help avoid surgery, if it is early capsular contracture. Mild cases can certainly be monitored until it becomes painful or more obvious. If it is a case of left implant descent, future revision may be necessary to improve the symmetry. Good luck with your journey!