Is this capsular contracture?

I'm a 52 yr old female who had breast augmentation in 1992. The implants are textured silicone from DOW. Although the left breast has always seems a bit more full and very slightly larger, I've never had any problems until now. Virtually overnight, my left breast became visibly larger, fuller, more firm, and higher up on my chest. There is no pain, no redness, no dimpling of skin, no malformation of any kind, only a much larger, fuller breast. I'm trying to get in contact with the original surgeon (he's retired and I live in another country now), and my current family doctor has no clue about implants. She ordered blood tests, which all came back fine and I have an ultrasound scheduled on Dec. 5th. Doing my own investigation, it seems to me to be capsular contraction so maybe I suddenly developed a leak and my body is reacting? Is it unusual to have capsular contraction after so many years? I've been massaging the breast and taking Epsom salt baths, but nothing has changed. I will start on vitamin E and I see research that Accolate can help. Honestly, I'm scared because I don't know what this is. I just want to know, it is normal for capsular contracture to occur 25 years after surgery? Could this just be an inflammation that will go down? If so, how should I treat the inflammation? Any and all professional advice would be most welcome!

The previous physicians have touched on very important issues. So, I will cover capsular contracture.

If a foreign object is introduced in the body, defense mechanism come in to play to deal with the intrusion. If the intrusion is biologic in nature, like a bacteria, the body will be able to destroy it. If it is an inanimate object, like a breast implant or a piece of metal, the body is unable to destroy it. It then resorts to isolating that foreign object from the rest of the body. It does that by producing scar tissue around it and it is called the capsule. When the capsule becomes too thick or too tight we call it "capsular contracture."

In your particular situation, if you did not have capsular contracture and you suddenly developed it, then your physician will have to identify the source of the new intrusion. It could be a rupture of the implant, an infectious process, etc.

M. Vincent Makhlouf, MD, FACS
M. Vincent Makhlouf, MD, FACS
9301 W Golf RdDes PlainesIL60016US

M. Vincent Makhlouf, MD, FACS

9301 Golf Road, #110, Des Plaines, IL,
60016, US

View

Hi. Your situation is not uncommon and can best be handled by a Board Certified Plastic Surgeon who performs breast augmentation regularly. It sounds like, after 25 years, your implants may not be in the condition that they first were-- whether this has happened slowly or suddenly-- most likely your surgeon will evaluate your breasts and implants with either an MRI or mammogram. In most cases, removal of the implants, releasing and removing capsular tissue, and maybe a lift procedure may be indicated. In my hands, I usually wait to perform a possible replacement of implants at a date 3 to 6 months after your breasts have healed from the surgery described. Of course, the best action is to be evaluated by a qualified plastic surgeon first hand and not rely on internet advice. Best wishes.

Anthony P. Terrasse MD, FACS
Anthony P. Terrasse MD, FACS
700 N Westmoreland RdLake ForestIL60045US

Anthony P. Terrasse MD, FACS

700 D North Westmoreland Rd., Lake Forest,
IL, 60045, US

View

This sounds like a contracture. I would recommend you see a board certified plastic surgeon to discuss it. An mri will help identify a leak.

Mark A. Eberbach MD
Mark A. Eberbach MD
14012 US-19HudsonFL34667US

Mark A. Eberbach MD

14012 U.S. Highway 19, Hudson, FL, 34667,
US

You have definitely done your homework. I believe you are correct in your diagnosis of capsular contracture. Implants that are 35 years old are most likely ruptured and need replacement. Contact a surgeon in your area.

Todd B. Koch MD, FACS
Todd B. Koch MD, FACS
6315 Sheridan DrBuffaloNY14221US

Todd B. Koch MD, FACS

6315 Sheridan Drive, Williamsville, NY,
14221, US

The most likely reason for the sudden swelling of your breast is a seroma (fluid around the implant). This type of seroma is usually caused by the textured surface of the implant tearing away from its previous attachments. This can seem like a capsule contracture; however, the rapid upset is most likely a seroma. Recommendations are as follows: 1) Ultrasound the breast in question. If there is a seroma, then some of the fluid needs to be removed and sent for CD30 immunohistochemistry, cell block cytology and culture. 2) If these tests are negative, which is the MOST likely outcome, then capsulectomy and implant exchange is recommended. I would also recommend a smooth walled implant to minimize, if not remove, this risk in the future.3) If the fluid is positive for CD30 ( which is EXTREMELY RARE), then you likely have Breast implant associated Anaplastic Large Cell Lymphoma. This is not a breast cancer. Treatment usually is total capsulectomy and implant removal on both sides. BEFORE any treatment is recommended, consultation with a plastic surgeon familiar with this entity and oncologist is recommended.

SUMMARY: Don't Panic. THIS IS PROBABLY BENIGN FLUID FROM TRAUMA TO THE BREAST. An operation can improve this condition. Get an ultrasound and fluid evaluation.

Plastic Surgeons around the world continue to collaborate on these exact issues and you should be able to find a colleague with the above knowledge.

Lawrence S. Glassman MD
Lawrence S. Glassman MD
978 NY-45PomonaNY10970US

Lawrence S. Glassman MD

978 Route 45, ste. L 5, Pomona, NY 10970

View

Thanks for your question. I'm sorry that you are having this problem. There is a phenomenon of delayed seroma in textured implants that occurs "just out of the blue". it is treated with capsulectomy and implant removal. New implants can be placed and they are usually switched to under the muscle if originally they were on top. The ultrasound you get should include an aspiration of fluid. There is an extremely rare condition called ALCL that can be seen in textured devices. Please realize that this is just precautionary and the likelihood is that this is just a freak but benign thing. It is easily treatable and hopefully you won't have any issues in the future. I just had one two weeks ago and have had two others in the last year. Best of Luck!

M. Scott Haydon MD
M. Scott Haydon MD
4701 Bee Cave RdWest Lake HillsTX78746US

M. Scott Haydon MD

4701 Bee Cave Road, Suite 202, Austin, TX,
78746, US

View

You should have an ultrasound to look for a fluid collection. If there is a fluid collection the treatment would be complete capsulectomy and removal of the implant. I would do the same for the other side. All fluid should be sent for bacterial and fungal cultures. Additional fluid should be sent to flow cytometry to rule out of abnormalities. The capsule should be sent to pathology.

Robert Whitfield MD, FACS
Robert Whitfield MD, FACS
7200 Wyoming Springs DrRound RockTX78681US

Robert Whitfield MD, FACS

7200 Wyoming Springs, Suite 1400,
Round Rock, TX, 78761, US

View