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

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.

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).

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