Capsular contracture AGAIN - what now?

I had my saline implants placed under the muscle eight years ago and in 2014 I had capsular contracture of the right implant. As a result, an open capsulotomy was performed by my surgeon and the original implant re-inserted. The area around the implant was found to be very inflamed, but I took antibiotics and anti-inflammatories after the capsulotomy and all was fine. Now the same has happened again. Less than two years later. I returned to my surgeon today and he suggested one of the following: 1) open capsulotomy again (after he tried a closed capsulotomy in the consult room with his bare hands), although he said the capsular contracture may likely occur again 2) remove the implants and replace with new ones - perhaps of a different texture, eg. silicone or foam-coated?? OR 3) remove implants and have breast augmentation involving the injection of my own body fat from one area and into my breasts. Problem with this is I don't have enough body fat to end up with breasts of a similar size to my current C-cups. Please help! I don't want to lose my implants, but don't know what the best option is!

April 13th, 2016 VIC

  • Answer
    Dr. Raymond Goh

    Raymond Goh

    123 answers

    Plastic Surgeon
    Queensland, Australia

    Hi Milly.
    Thank you for your post. I can understand your concerns. Although capsular contracture can occur in anyone who has had breast implants, early capsular contracture and recurrent capsular contracture can cause immense disappointment and frustration, for both surgeon and patient. Every breast implant patient will have some degree of capsule around the implant. This is the body's normal way of scarring around the implant. If the capsule becomes symptomatic (hardening, pain, distortion), then it is more appropriately called a capsular contracture. 
    If you have (symptomatic) capsular contracture, then a capsulectomy (removal of the capsule) is indicated. The question then lies in what to do after the old implants and capsule have been removed. One can consider placing the implants in a different pocket plane (for example, if the implants were originally placed over the muscle, one can consider putting new implants in under the muscle. As you have mentioned, the choice of implants can also affect the relative risk of capsular contracture.
    Without examining you, it's difficult to give specific advice or recommendations. I would suggest further discussion with your surgeon or a second opinion regarding your options.
    All the very best.
    Kind regards,
    Dr Ray Goh