American Society of Plastic Surgeons
For Medical Professionals
 
laurher
5 years ago
Answered

post breast augmentation complication capsular contracture

My left breast implant hasn't dropped, 3 months post surgery. It remains very high, about 2" below my clavicle, becoming deformed looking, and is more uncomfortable as days go by. Surgeon says it definitely needs revising surgery, but won't touch it till it's been 6 months. I don't see waiting another 3 months, when it's embarrassingly unsightly, and uncomfortable. What to do?

Procedure: Breast Augmentation
Location: simi Valley, CA

Replies 8

Daniel Careaga
ASPS Surgeon

Hi,

What you are describing sounds more like an implant malposition than a capsular contracture. I agree with your surgeon's recommendation to wait 6 months. This is an elective revision and believe it or not you are still healing and have inflammation so the last thing you want is to have a complication. Six months is a reasonable amount of time to wait before an elective revision.

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J. Gerald Minniti
ASPS Surgeon

My rule of thumb is to wait at least 6 months, because some mild cases get better on their own (the reason, I think, that the use of Singulair remains popular. It doesn't actually work, as demonstrated in clinical trials). However, if the cc is severe or getting worse, I think 3 months is long enough; it's not going to get better on its own, and any non-surgical modalities (high dose vitamin E, antibiotics, steroids, Singulair/Accolate, etc.) is ineffective. Go visit a few other surgeons. Best of luck!

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Aaron Stone
ASPS Surgeon

It's an unfortunate problem and there is no win win. If you go too early while the tissue is very biologically active the recurrence rate is higher. If you wait till things soften up the recurrence rate though still high is lower. If it's under the muscle and the distortion was caused by muscle spasm the redo with muscle paralysis during surgery will likely have a much lower recurrence rate than if it is due to the cells making up the capsule. Switching surgeons at this point is more costly and may not be productive.

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Jose Luis Valero
ASPS Int. Surgeon

Dear Laurer:

I’m afraid what your plastic surgeon is recommending to you is the most appropriate action and I suggested you to have the courage and patient to wait for this time to elapse and he/she surely will revise your breast- wish you all the best . Jose Luis Valero, MD

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Daniel Allan

Waiting is difficult but is appropriate. You can try wearing a "Breast Band" or ACE bandage positioned so as to push the implant down, although is is not likely to be a remedy for a truly mal-positioned implant.

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Nelson Castillo

Thank you for sharing your question and I am sorry to hear of your difficulties. Unfortunately timing always plays a large role in revisions as the tissues need to return to their previous appearance and "feel" before another surgery so as to minimize complications such as bleeding, while maximizing the outcome. Hang in there and allow more time to pass, your surgeon is giving you good advice. Hope this helps.

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Ron Soltero
ASPS Surgeon
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Laurher:

Waiting is the right choice. I seen some implants drop at 6 months after surgery, oviating the need for revisionary surgery. Try more massaging or a compression band.

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Shashidhar Kusuma
ASPS Surgeon

There are a lot of questions that will have to be answered which you and your surgeon know. Was this a revision case? was the placement under the muscle or over the muscle?, was there asymmetry (one larger than the other, droopier than the other) of the breasts prior to surgery? were the implants of the same size?( can have an effect on how they drop and how much, what incision was used? (some times placement can be difficult when done via the nipple/areola and or the armpit vs an incision in the breast fold, was a lift done at the same time? is there a distortion of the shape of the breast? and many more questions will need to be better understood. While the high position maybe malposition based on what your describe, but increasing pain could be contracture even at this early stage. work with your surgeon with regular follow ups and time the appropriate course of action, i.e revision, or other conservative measures.

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