Capsular Contracture

I know one of the most complications questioned right after surgery is the worry of Capsular Contracture. Mainly I think because of the hardening of the breast, so when all the swelling kicks in, at first that's mistaken for CC and then again if the swelling takes a little longer than they'd imagined for some they again start to worry that this is the cause.

So, as this is something I'm having to deal with myself right now I thought it may be helpful for some to be able to read the differences and what CC actually feels like to live with and the experiences that led to a diagnosis.

Capsular Contracture is one of the complications related to breast augmentation that can occur at anytime after the implant because implanted. It's your body's own way of rejecting the foreign body inside you. When you initially have your implant, at first a 'capsule' is formed around the implant originally to keep the body safe from the foreign body that's just been placed inside it. It's our body's way of protecting us from the unknown. This is what's meant to happen and the implant lives quite happily in there.

As the swelling kicks in our boobs can go very hard. This too is VERY normal, but I always think you should never ignore gut instinct. If you're overly concerned use your aftercare!!! You paid for it so don't be afraid to use it ladies - no matter how many times, so at any time in your recovery, never think it's too early, or it's been in a long time now, I'm OK.  Like I said, anytime after implantation you can get CC, whether that be 2 days post-op to 25 years post-op.

My experience went like this:

I was first feeling an aching in my breast, like when you've over stretched and you have that uncomfortable pain. I wear my sports bras to bed anyway along with at home a lot of the time so I knew they were getting plenty of support, none the less the discomfort confused but I did nothing about it (had other problems to think of)

The pain worsened over the months till it got so bad I couldn't lay on my side at all it was just far too uncomfortable. I could feel the differences in my breast as it went from being super soft to going super hard! The time it's taken to get so hard has happened over months, I'd say about 5 months. Now my boob is like a rock. I can feel the breast tissue surround the capsule which I thank goodness for because I think without this the folding inside itself of the implant would be visible, because I can feel this through the tissue.

There's no way, if I have choice I'm going to be able to leave the implant inside. The pain is just far too great now. So whatever happens, be it a rupture as well, or not (which I'll find out when I have an MRI) I just want to get the implants out and this is what I'm going to do.  I'm going through enough without putting myself through more and then when I'm fit to have a long surgery, which is what it's going to take to repair my boobs (it took 4 1/4 hrs last time) then I can make the decisions I want, whether that be fat transfer/Mastopexy or, Mastopexy/small anatomical implant, then these will be my last. I do want a bit of boobage, hence me needing to go through options before making up my mind...

So in a nutshell....I could feel this coming on but ignored what my body was telling me. I did everything I tell everyone to do on here - if you don't feel it's right - get it checked out!   

My boob (so far) hasn't distorted and 'looks' good, but the pain is bad. It's always there now and never goes away. Sleep is permanantly on my back now. I just can't bare pressure on my boobs if I lay on side, it's far too much pain. The cup size smaller bras I used to wear to give my boobs that bit more oomph have taken a back seat in my draw now because the pain of putting them on is enough to tell me not to go any further. There's no movement in the breast at all now and I can only wear 'comfy' bras now rather than bras that manipulate the look such as push ups and plunge, so it's strictly t shirt, comfort and sports bras for me now. That as much as I can bare.

So trust in 'you' ladies. You are the best judge over your own body. Nobody knows that body of yours better than you and yes, you may come here and we may say, don't worry how firm they are when you're very early post-op that's normal and IT IS! But for a VERY small percentage it may not be and we would always add to that if you're feeling overly concerned call your clinic and get to see your surgeon or nurse to have things checked over. It's YOUR call, but if you do feel so concerned you feel the need to have your boobs checked do ALWAYS get that concern noted. This is so, so important for any concerns you have throughout your recovery.

I did scour the forum for 'real information' from a member here, but found nothing so I hope this has been of help to at least some of you. 

Thanks cookie I'm sorry to hear you are going through this, I started getting it on my left. I noticed when I gently pushed both breasts the one was a lot firmer, and although I'm only stage 2 cc, the scar tissue is getting lumpy or missing shaping the implant so when I lie back my left one is lumpy as I don't have mch breast tissue. As my surgeon is changing my implants anyway,  this is a secondary thing that will be sorted with that. There's no guarantee it won't return though. I agree I think it's important to highlight to ladies that breast surgery is not one operation for life. Would be lovely if it was. I would like to know more about fat transfers, in the future this might be the way forward. X

Cookie Cookie Cookie!!! when are you going to get a blooming break, boob wise and health wise!!

At least you now know what it is and that it hopefully can be sorted out some way, whatever way is best for you now and the for the longterm future

As you know I had the pain with my CC and thats what made me need to have the reop but I also had the look of CC

I hope that that you get this all sorted soon and Im glad that you came and spoke about it   

Sorry to hear about your trouble Cookie. I hope you get it sorted.

I looked at fat transfer as it looked like an ideal path to bigger boobs. Unfortunately, it doesn't appear to be permanent and the most worrying concern for me was the possible increased risk of cancer in the injected fat cells.

Stem cell research looks promising too, although currently it looks like it may only suitable for a one cup size increase. Who knows, in a couple of years, they may be able to grow a set of implants from your own cells to whatever size you want with no risk of rejection.

Do you think your pre-existing health issues contributed? Your lowered immune system causing your body to overreact and increase the capsule production? Is it something you've discussed with your Dr's? I just worry that my recent health scare may lead to future problems. Are there any links? (sorry, lots of q's!)

This is undoubtedly my biggest worry and think it will always be in the back of my mind up to a certain extent. 
You poor girlies, sending lots of love xx

loui1981 wrote:Thanks cookie I'm sorry to hear you are going through this, I started getting it on my left. I noticed when I gently pushed both breasts the one was a lot firmer, and although I'm only stage 2 cc, the scar tissue is getting lumpy or missing shaping the implant so when I lie back my left one is lumpy as I don't have mch breast tissue. As my surgeon is changing my implants anyway,  this is a secondary thing that will be sorted with that. There's no guarantee it won't return though. I agree I think it's important to highlight to ladies that breast surgery is not one operation for life. Would be lovely if it was. I would like to know more about fat transfers, in the future this might be the way forward. X

Sadly there's never any guarantees with this surgery Loui   

Have yourself and your surgeon discussed polyeurothane implants Loui? Along with going under the muscle? These both do help reduce the risk of CC with polyeurothane implants proven to have the lowest risk of all implants of getting CC again. If you haven't already discussed it Loui, it's definitely worth doing so before your surgery. I'm sorry youre going through this too   

tinkerbell24 wrote:Cookie Cookie Cookie!!! when are you going to get a blooming break, boob wise and health wise!!

At least you now know what it is and that it hopefully can be sorted out some way, whatever way is best for you now and the for the longterm future

As you know I had the pain with my CC and thats what made me need to have the reop but I also had the look of CC

I hope that that you get this all sorted soon and Im glad that you came and spoke about it   

Awww Tink, hello darling   

So you finally had your revision hey! How did it go hun? And why do you have to have more revision? Xx

Hellsbells wrote:Sorry to hear about your trouble Cookie. I hope you get it sorted.

I looked at fat transfer as it looked like an ideal path to bigger boobs. Unfortunately, it doesn't appear to be permanent and the most worrying concern for me was the possible increased risk of cancer in the injected fat cells.

Stem cell research looks promising too, although currently it looks like it may only suitable for a one cup size increase. Who knows, in a couple of years, they may be able to grow a set of implants from your own cells to whatever size you want with no risk of rejection.

Yes, I too have been looking into the stem cell. If I can get a C cup from my own natural breast tissue then another cupsize would be great for me. A D cup is something I'd be OK with. As much as I'd prefer to have no breast implants, the need for a bust is just something I have to have. I just couldn't go back to no boobs, so until I speak with my chosen surgeon there's nothing to discuss yet until he has the images in his hands. Not only will he know what he's dealing with, he'll also know the thickness of breast tissue I want. I am fully aware though that if I have a rupture too I'm likely to lose some breast tissue if I have to have another capsulectomy and IF the silicone has bled, that again makes things a little more difficult, so right now...I'm just gonna wait and see - thank you for adding the info though Bells   

Charlii wrote:Do you think your pre-existing health issues contributed? Your lowered immune system causing your body to overreact and increase the capsule production? Is it something you've discussed with your Dr's? I just worry that my recent health scare may lead to future problems. Are there any links? (sorry, lots of q's!)

Unfortunately I do Charlii. Both consultants and GP have confirmed this. If you visit any website about CC they all comment on illness leading to a lowered immunity as a factor leading to CC. I haven't actually researched beyond that Charlii because my heads all over all over the place right now. But what I will say Charlii is that we're all different and along with my having a lowered immunity, I also have a condition whereby my body attacks itself and it's very likely that in 'my' case the sarc was very much the factor helped along by the lowered immunity.

Maybe a chat with your surgeon or your rheumatologist might help ease your worries babe and if they can't do that then at least have you informed. I see you as a logical woman and once you have all the info, be that good or bad, once processed - you can deal with that. It's the 'not' knowing that troubles you and I fully understand that.   

sharonmcc1979 wrote:This is undoubtedly my biggest worry and think it will always be in the back of my mind up to a certain extent. 
You poor girlies, sending lots of love xx

I can only speak for myself but please don't pity me Sharon. I knew exactly what I signed up for when I agreed to having this surgery, so I really can't moan once it's here, the only thing I can do now is deal with it. Fortunately I do have a booby fund, trouble is health right now and that comes first. So I'll just do what needs to be done for now once I have the info and then when I'm feeling better I'll have my perfect boobs once again...albeit a lot smaller lol. Xx

I haven't had this next lot of revision just the one I had to sort the CC ect last dec

I need my implants moved to over muscles and uhp instead of mp

So what's ur next step then xx

Ah I'm so sorry to hear this Cookie but so glad to hear you've found the issue and can now take steps towards getting healthy and comfortable.

RE: Health issues contributing, sadly this can be the case, I have done a lot of research on this as I like both you Cookie and Charlii have on going health issues. My body recently sent my lymphatic system in to overdrive which caused my body to reject all of piercings, some of which I have had for over 10 years, it also caused me to get an itchy rash all over the area where my contraceptive implant is placed and also across the chest area. It's something a lot of Drs are up in the air about but there is something called Siliconeosis (sp) that occurs in women with implants who have auto immune illnesses, your body exhausts it's self by trying to constantly flush the foreign body, it doesn't always cause CC but it can lower your immune system and leave you open to infections which can be a contributing factor, bacteria in the blood stream is believed to be a main cause.

How ever when I spoke with Dr's here they said that in general terms your chances of CC are something that is predetermined by your genetics, much like hyper tropic scarring and keliods, it's kind of an open question with no concrete answers unfortunately. 

Hope all goes well Cookie and I hope you can get the info your after Charlii.

tinkerbell24 wrote:I haven't had this next lot of revision just the one I had to sort the CC ect last dec

I need my implants moved to over muscles and uhp instead of mp

So what exactly did your surgeon actually do on that revision Tink? You'll love overs by the way  

So what's ur next step then xx

Next step is get 'em out ASAP Tink. The pain just isn't worth keeping them in until I'm well enough to go through the reconstruction surgery.

KayDeeStafford wrote:Ah I'm so sorry to hear this Cookie but so glad to hear you've found the issue and can now take steps towards getting healthy and comfortable.

RE: Health issues contributing, sadly this can be the case, I have done a lot of research on this as I like both you Cookie and Charlii have on going health issues. My body recently sent my lymphatic system in to overdrive which caused my body to reject all of piercings, some of which I have had for over 10 years, it also caused me to get an itchy rash all over the area where my contraceptive implant is placed and also across the chest area. It's something a lot of Drs are up in the air about but there is something called Siliconeosis (sp) that occurs in women with implants who have auto immune illnesses, your body exhausts it's self by trying to constantly flush the foreign body, it doesn't always cause CC but it can lower your immune system and leave you open to infections which can be a contributing factor, bacteria in the blood stream is believed to be a main cause.

How ever when I spoke with Dr's here they said that in general terms your chances of CC are something that is predetermined by your genetics, much like hyper tropic scarring and keliods, it's kind of an open question with no concrete answers unfortunately. 

Hope all goes well Cookie and I hope you can get the info your after Charlii.

I'm sorry to read all you've gone through KayDee   and I'm very thankful for the starting point of Siliconeosis. I'll look that up   

Overs are fantastic, defo love em Tink!

Thanks Cookie and no probs, it's one of those things they can't seem to agree on at the moment but worth a look. I hope things start to look up for you soon, you've been through so much all ready.

Hi, I am not sure if they would do unders on my cookie as they are changing the implants from rounds to teardrop as I have snoopy dog deformity, also opening the pocket a bit. The cc is too early for them to usually consider revision surgery but as they are removing the implants anyway it's an added benefit. I could ask my coordinator as my left one has so little tissue. Only thing would be that they are filling me out as I have droopy tissue under the implant. If I had unders they may need to do a lift as well and I'm not sure they would want to do that? X

I will do some research on this as well for you cookie as I'm a microbiologist, also studied virology and immunology too, so will get looking into it. X

Y'know I was so focussed on just trying to get better, I didn't even think of the ramifications on my BA. Dads first reactions was 'did your boobs cause it', but that was my first Q to the rheumatologist also, with a firm no to causing. But AOSD is auto immune too, and there's just no knowing if I'm now 'cured' or whether its going to come back in 6m, 6yrs, 60yrs.

Luckily I have my next app with the rheumatologist in 4wks, and am due my 1yr app with the surgeon in Sept, so I've got some time now to research, and put together a bunch of questions. Fingers crossed, this is a one off and I don't get hit again, and it doesn't affect my boobs. Like you, I just could not go back to being without, that's not an option right now, and hopefully, its not an option I'll have to consider.

(PS, my inflammation is back to normal human being levels now, yey! I wore real shoes for the first time in 10wks!)

loui1981 wrote:Hi, I am not sure if they would do unders on my cookie as they are changing the implants from rounds to teardrop as I have snoopy dog deformity, also opening the pocket a bit. The cc is too early for them to usually consider revision surgery but as they are removing the implants anyway it's an added benefit. I could ask my coordinator as my left one has so little tissue. Only thing would be that they are filling me out as I have droopy tissue under the implant. If I had unders they may need to do a lift as well and I'm not sure they would want to do that? X

Ahhhhhh, sorry Loui, I do remember now that you'd told me already about not being have understand    xx

loui1981 wrote:I will do some research on this as well for you cookie as I'm a microbiologist, also studied virology and immunology too, so will get looking into it. X

You'd do that for me?!!!!! Awwww Loui, im so, so touched - thank you. I really do appreciate that   

Charlii wrote:(PS, my inflammation is back to normal human being levels now, yey! I wore real shoes for the first time in 10wks!)

That's fantastic news Charlii. I'm so happy for you   

My legs are tree trunks right now with pigs trotters on the end they're so swollen   

KayDeeStafford wrote:Overs are fantastic, defo love em Tink!

Thanks Cookie and no probs, it's one of those things they can't seem to agree on at the moment but worth a look. I hope things start to look up for you soon, you've been through so much all ready.

Yes, so I'm finding. And I can't seem to find anything past 2005? But I've just started looking so I don't doubt there's more to find as I dig further. But so far, from what I'm finding more of is that there's no scientific evidence to support the allegations    xx

I had a little look last night, didn't find much but did end up scaring myself when I found a leaflet by allergen, warning the risk of cc jumps up from 16 to 21 percent comparing primary ba to when u have a revision ba.

16 percent? 

Hmmmm... starting to wonder if I like those odds.

Given that infection seems to be the main culprit for CC, I wondered if the use of drains might be a contributory factor, given that they might provide a way in for unwanted bugs. They also seem to be used more often following revision surgery.

I found this study which appears to say that the opposite may be true...

[You must be registered and logged in to see this link.]

Cookie your resilience is inspirational! I wish you lots of luck in whatever you decide.

Hellsbells my surgeon uses drains for all BAs as he believes they lower the risk of infection/cc by removing the fluid/blood that will surround the implant when first implanted preventing a biofilm to build. He insists all his ladies stay in hosp 2 nights, so that drains can remain in for 48 hrs. No idea if his hypothesis is correct, but hoping so!! My drains drained less then 100ml, but even so he made me keep them in until he was certain there was nothing left to drain!!

Mammamia wrote:Cookie your resilience is inspirational! I wish you lots of luck in whatever you decide

Thank you sweetness. That's very kind of you to say   

Just jumping in on the drains topic - it's interesting for me to read that it's being said having drains may raise your risk of CC, because my first BA I didn't have drains, but my second I did and now I have CC - coincidence? Or or I'm just an unlucky sod destined to have a couple of fried eggs lol.

Most surgeons will use drains for revision surgery.

Many surgeons do believe that drains can be a risk of infection, hence the big surgery row over whether or not they of any help.

Complications do heighten the risk of infection anyway after surgery, which is why using drains after a complication (if it's required - some of the easier surgeries for surgeons and they don't feel they're necessary) if felt to be of some benefit because they then aren't heightening the risk when risk is there anyway.

I hope you understand that lol. Xx

I think the only proven *method* as it were that reduces the risk of CC is the Keller Funnel or Rapid Recovery, it's basically a big icing/piping bag they use to deliver the implant from it's package to your body. It's a no contact method, the implant is never touched from the moment it's package is opened so it's said to reduce bacteria and the like. This is why some Dr's feel drains increase the risk, there is more of an opportunity for bacteria to collect, the thing is there are no real right or wrong solid answers when it comes to BA. Each Dr has their own reasons, beliefs and methods that they feel reduce risks, there is no concrete evidence that one way is the right way. It's also dependant on your own body and immune system. Also most info sheets will use clever wording to make the risks seem lower, rather than say X% of ladies are affected by CC they will say X% are affected in this way in this number of years and then after that this number of years, splitting the total number in to smaller ones.

In general terms, your risk for CC does increase with every surgery, many of us will be affected at one time or another as we all have a capsule around the implant anyway, it's just a case of how fast that capsule starts to shrink. Every clinic, Dr and manufacturer will give you different percentages on CC as with most things BA related they don't want to scare you off, one Dr I spoke with said in reality the number of women affected sometime during the lifetime of the implant is around 35% with that figure rising if they leave the implant in place for longer than it's recommended lifespan or if they have other surgeries.

In the end I found a book on it Cookie, I will have to hunt it down for you,, it is again though one of those things that has no exact proof aside from a large number women who claim to have had health issues following a BA that were not there prior, I found a lot of info from ladies on US based sites, it's hard to get real information at all, even from Drs, if it's not something they specialise in they don't know, if they do know they are reluctant to say so as it's bad for business. I know it's very cynical but I do think that most Cosmetic Drs are cowboys to some extent, they will give you as little information as they can to try not to scare you off or stop you recommending surgery to others.... again, I know I sound like a negative person but that is just how it looks to me! Not that they are out to hurt you or anything, I just feel they don't like you to be as well informed as you could be.

KayDeeStafford wrote:I think the only proven *method* as it were that reduces the risk of CC is the Keller Funnel or Rapid Recovery, it's basically a big icing/piping bag they use to deliver the implant from it's package to your body. It's a no contact method, the implant is never touched from the moment it's package is opened so it's said to reduce bacteria and the like. This is why some Dr's feel drains increase the risk, there is more of an opportunity for bacteria to collect, the thing is there are no real right or wrong solid answers when it comes to BA. Each Dr has their own reasons, beliefs and methods that they feel reduce risks, there is no concrete evidence that one way is the right way. It's also dependant on your own body and immune system. Also most info sheets will use clever wording to make the risks seem lower, rather than say X% of ladies are affected by CC they will say X% are affected in this way in this number of years and then after that this number of years, splitting the total number in to smaller ones.

In general terms, your risk for CC does increase with every surgery, many of us will be affected at one time or another as we all have a capsule around the implant anyway, it's just a case of how fast that capsule starts to shrink. Every clinic, Dr and manufacturer will give you different percentages on CC as with most things BA related they don't want to scare you off, one Dr I spoke with said in reality the number of women affected sometime during the lifetime of the implant is around 35% with that figure rising if they leave the implant in place for longer than it's recommended lifespan or if they have other surgeries.

In the end I found a book on it Cookie, I will have to hunt it down for you,, it is again though one of those things that has no exact proof aside from a large number women who claim to have had health issues following a BA that were not there prior, I found a lot of info from ladies on US based sites, it's hard to get real information at all, even from Drs, if it's not something they specialise in they don't know, if they do know they are reluctant to say so as it's bad for business. I know it's very cynical but I do think that most Cosmetic Drs are cowboys to some extent, they will give you as little information as they can to try not to scare you off or stop you recommending surgery to others.... again, I know I sound like a negative person but that is just how it looks to me! Not that they are out to hurt you or anything, I just feel they don't like you to be as well informed as you could be.

I absolutely agree KayDee. I can find no relevant information that is up to date and I fully understand what you're saying about surgeons and protecting their 'business' but.... As long as surgeons tell their patients there are risks involved and lists off the main ones, we, who are wanting to have this surgery also have a responsibility to ourselves and our body too and it's up to us to listen to what the surgeon said, research the surgery plan and the complications you were told about, I've gone though 4 surgeons and all but one did tell me that CC is a risk after surgery. I looked up CC along with the other risks and more and then went back to see the surgeons and questioned anything I didn't fully understand - of course surgeons are only going to tell us on a 'need to know' basis, but the responsibility I personally feel doesn't just lay with the doc, but with us too.

Thanks for trying to find the book for me gorgeous.  

I had the capsulotomy my muscles released and breast crease lwered

im scared of overs lol

Aw yeah the pain can be really unbearable and I get why you just want them sorted

Cant believe you are having more implants problems   
Capsulotomy
Capsulotomy

I remember now hun.   

There's nothing to be afraid of Tink. You'll love 'em!   

Here's you changing placement to overs and if I do have more implants, I'll be having partials lol.

Do you have a date now for your next revision?