capsular contracture

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voicewriter
voicewriter Member Posts: 51
edited September 2018 in Breast Reconstruction
capsular contracture
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  • voicewriter
    voicewriter Member Posts: 51
    edited March 2012

    Hi. So I had bilateral reconstruction with silicone implants in May, and all was good.  There was a little divet at the top of my left breast that was bothering me, so as I was scheduled to have my nipples reconstructed, I elected to have a little fat grafting from my abdomen injected into the divet.  All went well, it looked pretty good, and then the left breast seemed to be getting higher than the right.  Went to see my plastic surgeon, and indeed, the right one seems to have dropped a bit, so they are not even.  I'm supposed to go in for surgery to have the right one lifted -- which involves removing the implant and replacing it, and shoring up the capsule, but my bigger concern now is the left one, which seems to be hardening.  It's very firm, and doesn't budge an inch.  The two surgeons where I go, both very professional (here in Boston) say there is mild capsular contracture on the left, but I seem to think it's more than mild.  Also, the left one is warm to the touch all the time, while the right one is cold, as it should be.  I am so stressed out from this.  I was feeling pretty good about how I was looking and feeling, ready to move on and be done with this, and now don't know what to do.  Has anyone else here at capsular contracture of any kind, and what did you do?  What did your surgeons say or do?  Thanks! 

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  • dogsandjogs
    dogsandjogs Member Posts: 1,907
    edited March 2012

    I probably can't help much as I had my reconstruction in 1982! The silicone implant seemed ok for the first year or two, but then moved higher and to the side and became quite hard. I never saw the PS afterwards, but my surgeon never seemed concerned. After years of mammograms, the techs never commented on it either so maybe it is not that unusual?

    In any case I decided to do nothing as I didn't want any more surgeries. When I was diagnosed with a new primary in the other breast last year, the MRI showed the old implant had a small tear. But the radiologist said it wasn't leaking. When I asked my BS he just said 'You'll have to ask a plastic surgeon."  But now, after reading these post, I'm wondering---is encapsulation dangerous or does it affect your health in any way?  If I was still young I would be more concerned so I understand why you are disappointed and concerned.   Hoping someone else will answer your post! 

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  • Junebug40
    Junebug40 Member Posts: 71
    edited March 2012

    I had a capsular contracture about 9 months post exchange. What had started out as a "little uneven" began to get really noticeable. The capsular contracture was on my affected side. From what I have read those who have gone through radiation have a higher risk of encapsulation. It can be fixed. Your insurance also covers this.I have had several revisions since exchange for numerous reasons. It was a very fast and simple procedure. Best of luck to you 

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2012

    voicewriter- Sorry, I know this sucks!  Unfortunately, for those of us with implants after MX we have a higher rate of CC and I think something like 47% of us end up having to do a revision for one reason or another.  I developed CC about 6 months after exchange and had to do this.  I had both implants swapped out for smaller and then did extensive fat grafting over the top.  It has now been almost a year and no CC so far.  I wanted to mention, though, that the fat grafting helps cover up the coldness of the implants.  Mine were always much colder than the rest of me until I did the fat grafting.  Now they are as warm as the rest of me.  Since it's only your left that's warm, and that's the one you had the fat grafting, I'm guessing that's what's going on.  If you do end up having to do a revision you might want to think about more fat grafting.  There's some theories that it helps with CC.  Good luck to you.

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  • voicewriter
    voicewriter Member Posts: 51
    edited March 2012

    Kate, yes, it sucks.  In fact, the fat grafting I had was only in one small spot on the top, but the whole boob is warm.  I see the surgeon tomorrow for a pre-op to go in Friday to hoist up the right one, as scheduled, and I know they're not too keen on touching the left one for now, which is the one with the capsular contracture -- I don't know why they don't want to -- but I am going to push for it.  They're going on, might as well do both.  We shall see.  I want MY boobs back, small and starting to sag as they were.  Wishful thinking, lol. 

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2012

    voice- Have you ever heard of taking Singulair to stop capsular contracture?  Some research shows it helps and some doctors have started prescribing it.  Here's a short article about it but you may want to look into it more.  Might be worth trying to avoid another surgery after this one.  Good luck with your upcoming one.

    http://blog.plasticsurgeryinflorida.com/2010/07/singulair-and-capsular-contracture.html 

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  • lago
    lago Member Posts: 17,186
    edited March 2012

    voicewriter does your PS have you massaging your implants? I was told by my PS to do it every day. I had my exchange last June with some fat transfer. In October I had nipple recon, more fat transfer (because my PS couldn't find enough on my stomach/love handles) and a revision to lefty because it sat a bit lower. Mine move pretty well in the pockets although I would say righty is not quite as soft but only I would notice. I didn't have radiation (still not sure how I got out of that one).

    But as others say they can fix this. I hear youb about not wanting another surgery. As of Feb 7th when I got my tattoos I am done… well except for the port but I have another 1.5 year with that thing.

    BTW I used to live on Euston St. in Brookline just over the Boston border in 2011. Also grew up on the S. Shore.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2012

    lago - how often, and for how long, are you massaging?  I just started doing it (2 weeks post exchange) and I got a demo from PS but forgot to ask how many times a day, etc.  He added that I should do it at stoplights or when stuck in traffic, lol!

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  • lago
    lago Member Posts: 17,186
    edited March 2012

    I got the vague answer too. I just asked him again last Wednesday when I was doing follow up on the tatts. He said a couple times a day. Push up for 20 seconds. Do it a "couple of times" per session. What ever I'm doing I guess I'm doing the right thing because he was really pleased with their mobility in the pocket.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2012

    lago - thanks!  He has me push at the 12,3,6 and 9 o'clock positions, in opposite directions.  I was probably not holding the push long enough though, so I appreciate the additional detail.

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  • MuddyGlasses
    MuddyGlasses Member Posts: 10
    edited March 2012

    Massaging it every day will help, and my PS suggested also moisturizer 3 or 4 times a day -- "Keep them tacky to the touch". The simple act of putting on the moisturizer and massaging the breasts helps. Putting on so much moisturizer is a bit annoying on the clothing, but I wear a camisole under my tops to avoid too much mess.

    Good luck with it,

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  • lago
    lago Member Posts: 17,186
    edited March 2012

    My PS stresses being very agressive. He says most women are not, also mentioning we can't break them.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2012

    I was told by my original PS not to massage if you get Alloderm over the breast as it can prevent it from fully integrating.  And I was told by the PS who did my revision not to massage if you've had fat grafting as it can break down the fat and cause it to be reabsorbed.  It's so frustrating to hear different things from different surgeons.  I wish they would all get on the same page. 

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2012

    My PS did mention the level of aggressiveness - he said I should push like I am pushing up to the shoulder. 

    kate33 - I had alloderm but it was put in when TE's were placed, which was a long time ago.  My BMX was in Nov. '10, and I just had my exchange a couple of weeks ago.  My PS does not do fat grafting until quite a bit later.  I will ask about that during my next appt though.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2012

    SpecialK- I had built up some scar tissue after my revision and was working with a PT who was doing some pretty aggressive manipulation as well as ultrasound to try and break it up.  When I mentioned it to my PS he told me to stop as it could cause all the fat to reabsorb.  I've never heard anyone else ever mention this before, though.  

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2012

    kate33 - I remember you went to see Dr. Khouri, was this after that revision? 

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  • lago
    lago Member Posts: 17,186
    edited March 2012

    I have yet to see any absorbtion. Maybe its the way you "massage". My PS just has me pushing them up.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2012

    lago- That must be it.  The PT I used was pushing down on the scar tissue and manipulating it.  It's good to see you didn't see any effects.  

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  • voicewriter
    voicewriter Member Posts: 51
    edited March 2012

    So just came from seeing my PS, and we are going to replace both implants - YAY! - the one with the capsular contracture, and the one that has drooped and shore that one up.  I think they're actually a little too big, so she's going to put a little smaller implant in, which I want, anyway.  I am so relieved to get rid of this ball on my chest!  Thank you all for your comments and support.  I will let you know how the new "girls" look after Friday!   :)

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  • KSteve
    KSteve Member Posts: 486
    edited March 2012

    Voicewriter - I think I'm going to be in the same position as you.  My right side (which was radiated) has really tightened.  At first I figured it was due to the radiated skin, but now I'm thinking it must be capsular contracture.  The one on the left has dropped some and migrated to the side some, and I'm also thinking they might be a little too big.  I'll be anxious to here if you get relief from this surgery.  I'm going on a 10-day vacation (first one since completing treatments) so I'll make an appointment with my PS when I return.  Please keep me posted on your progress!  I'll be thinking of you.

    Kathy

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  • voicewriter
    voicewriter Member Posts: 51
    edited March 2012

    Kathy, yes, it sounds like you have a similar situation.  I am looking forward to getting this "ball" out of my chest.  I don't know how people live with these capsular contractures.  It's such a drag.  When I go to yoga and lay on my stomach, my left breast keeps me elevated, lol.  It sucks, and I'm sorry you're going through the same thing!  I will post and let you know how I'm doing.  Of course, it's going to be nice and soft at first, but I'll post anyway to let you know how it went. 

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  • SuebeeBC
    SuebeeBC Member Posts: 1,256
    edited March 2012

    Kate - thanks for the article about singulair!!!  I had no idea! But I take it every day for my asthma.  Its great that they are finding good alternate uses for drugs out there.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2012

    Suebee- Great to take a drug that does double duty!  :)

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  • KSteve
    KSteve Member Posts: 486
    edited March 2012

    Voicewriter - Thinking of you today.  Hope everything is going well.

    Kathy

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  • voicewriter
    voicewriter Member Posts: 51
    edited March 2012

    Hi there.  Kathy, thanks for thinking of me.  Surgery went well, I a bit sore, more than before.  And a bit loopy from the drugs.  At least I'm not nauseous!  They're bandaged up, so when they are revealed, I will post more. The right one . now is a higher than the left, but hoping they will even out with swelling, etc.  This whole process sucks.  I can't for the life of me understand why anyone would get breast augmentation just out of vanity.  Do they have this much trouble?  Well, at least the CC is done, hopefully never to return.  MY PS said about 20% get them, and about 5% reoccur.  Hope I'm not in that 5%!

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  • KSteve
    KSteve Member Posts: 486
    edited March 2012

    Glad the surgery is done and hopefully you're able to rest with the help of pain pills! I hear you about this whole process sucking! But you didn't come this far to settle for less than good results. Besides the cc hurts so not much choice there. I know what you mean about boob jobs ... Why would anyone choose to go through surgery? Hopefully you can relax this weekend. How long are you taking off from work?

    Take care,

    Kathy

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  • voicewriter
    voicewriter Member Posts: 51
    edited March 2012

    I'm actually only sore, no need for pain meds.  In fact, I didn't need any after my mastectomy or the original implant surgery.  I'm going back to work Monday!  Hard to believe, isn't it??  But keeping a low profile over the weekend -- no yoga, not going out too much, so I can heal. 

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  • Fearless_One
    Fearless_One Member Posts: 3,300
    edited March 2012

    I am confused as to how switching implants prevents future CC?   Can anyone explain this to me?   Also, how does changing to a smaller implant prevent a new capsule from forming later?  

    I think I may be getting cc on my rads side.

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  • voicewriter
    voicewriter Member Posts: 51
    edited March 2012

    Changing implants doesn't prevent future CC.  I opted for smaller implants mostly because I thought the others were a bit too big for me, and since she had to go in anyway, I asked for smaller.  The CC I had in the left breast is now gone, because I think she took out the capsule -- not sure exactly what she did.  Will ask her when I see her.  I hope you're not getting CC, Fearless_One, but if you are, go see your surgeon and see what they say.  Good luck! 

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  • Fearless_One
    Fearless_One Member Posts: 3,300
    edited March 2012

    I am glad your CC is gone and that you are feeling okay !   Ok, I misunderstood.   I thought you went smaller to prevent CC.     I asked PS if he thought I had CC and he said "no, not from what I can tell, not "yet".     But I just know it feels very "tight" and is a bit higher than lefty.   Are those signs?

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