I had a consult with the provider who performed this procedure who informed me he could take the cannula and attempt to break up the mass then leave the clumps within the breast pocket. He said he hadn't seen this before so he is not sure why this happened or even what it is. He said perhaps the breasts would be less lumpy or maybe the body would digest the clump once it was broken up? I am not sure if I should let him do this or if it will make it worse. Any ideas would be greatly appreciated.
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I am 7 months post op from BA with lift and have acute capsular contracture in both breasts. My implants (450cc, SRF) were placed UTM. My surgeon will perform a capsulotomy and replace with a smaller 365cc implant. Would you advise against the exchange?
Capsular contracture may occur for various reasons such as sub-clinical bacterial contamination of the implant during placement, oversized implants for the breast pocket, genetic predisposition, and others. Overall, the rate of capsular contracture is approximately 1% per year. To minimize a patient's risk of developing capsular contracture, I recommend an inframammary incision (vs periareolar or axillary/armpit), submuscular implant placement, use of an implant funnel/no-touch technique, atraumatic technique, and aseptic pocket wash among other technical considerations. Once a contracture has developed, the best technique to reduce the risk of recurrence is to remove and replace the implant in a new plane.
Thank you so much for this question. Capsular contracture unfortunately is a known complication of breast implant surgery occurring 1% per year for a patient. In your case the risk would be 1%. Patient risk factors typically include any nicotine usage. The exact etiology is unknown but the most commonly accepted cause is bacterial colonization of the implant leading to the encapsulation. The most common treatment is implant exchange and 'pocket change'; meaning if you are on top of the muscle placing the implant below the muscle, or if you are below the muscle making a neosubpectoral pocket (new submuscular pocket). The site change is key as it helps to place the implant away from the presumed bacterial source.
In our practice we also are sure to copiously irrigate the pocket with several different antibacterial solutions to cleanse the area.
I would advise to make sure you are consulting with a board certified plastic surgeon who specializes in aesthetic surgery; a member of the Aesthetic Society illustrates this fact.
Thank you again for your question and best of luck.
I've had breast implants for 22 years- the first 20 were with saline implants with no issues. 2 years ago, I had my breast implants redone with silicone with no issues until now. In the last few days, each breast has started to make what equates to cracking/crunching noises but with no pain. What could this be?
Thank you so much for your question.
It is hard to determine what is occurring with the sound you are hearing. It may be a temporary issue or could be due to capsular contracture. The first thing I would have my patient is to have a mammogram/ultrasound to determine if the implant is intact without any signs of rupture or capsular contracture. I would also encourage you to schedule a consult with your board certified plastic surgeon to evaluate for any clinical signs of capsular contracture.
Thank you for your question and best of luck.
Hard lumps following fat transfer can occur particularly when larger volumes of fat are transferred and not adequately dispersed throughout. Depending on how long ago your surgery was, you may have developed "fat necrosis" which is where the fat cells failed to "take" sufficiently and have now died. Your body naturally encloses this clump of cells and forms a firm nodule. Depending on the size, they may need to be surgically removed to fully address the firmness. Smaller nodules may be adequately addressed with steroid injections and massage. As always, any new lump in the breast should also be evaluated for malignancy, however, given your recent surgery this is not the likely culprit.