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Capsular contracture following implant surgery
Four months after having my reconstruction surgery with gummy bear implants my right breast was higher than my left. Assuming it just hasn’t fallen I left the surgeons office saying I should wait it out. I then had a flu shot. The next day that higher breast became swollen, red and painful. I had a cat scan and it showed a seroma under the implant. The surgeon did emergency surgery and said I had capsular contraction - scar tissue encapsulated the implant and we won’t ever know if it was the flu shot that caused my immune system to go into overdrive and attack the implant or the Seroma was there and caused it or why this happened. Emergency surgery was scheduled and he had to remove the implant and the pocket it was in and all the scar tissue or capsular contraction. He put in another implant 5 weeks ago and I am healing. Has anyone had this happen ? I am told since I had one capsular contraction that it could happen again. I just have to wait a year to see if this new implant now will fall to be like the other one - more natural or whether he will have to raise the left one to match it at some point. Always hoping this doesn’t happen again. I am curious if anyone out there has experienced something like this happening to them. Obviously if it keeps happening I will either have to consider flap reconstruction or going flat. Either way that would require more surgery too. The surgeon doesn’t want to operate again on the right breast since I have had three surgeries since February when I had my bilateral mastectomies after an invasive lobular cancer diagnosis. It was HR positive and Hers negative and stage 1A not in my lymph nodes so while I am on letrozole I avoided chemo and radiation. Thanks for your insights all.
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You might want to ask your doctor about this study and if it applies to you. The take-away might be to stop letrozole temporarily. They may also have studies that show which hormone therapy may cause you the least issues while healing. I’m not suggesting to completely stop taking an AI, just temp.
From Science Direct
The link below has more info and DOI link that will take you to the research.
“ Discussion
This study shows that tamoxifen and AIs seem to be associated with an increased risk of wound healing complications (fat necrosis, infection, and delayed wound healing), regardless of the type of breast reconstruction performed, and with an increased risk of Baker's grade III or IV capsular contracture in the case of prosthetic reconstruction. Hormone therapy did not seem to significantly increase the risk of microvascular thrombosis or VTE for breast reconstruction.
Conclusion
In our study, hormone therapy, including tamoxifen and AIs, appeared to be associated with a higher risk of postoperative wound healing complications and capsular contracture.
Our study suggests that temporary discontinuation of tamoxifen or AIs could help limit wound healing complications that may sometimes lead to the failure of the reconstruction, especially in the case of prosthetic reconstruction. A prospective cohort study should, however, be conducted to confirm our findings. . . .”
https://www.sciencedirect.com/science/article/abs/pii/S1748681517302243#:~:text=This%20study%20shows%20that%20tamoxifen,or%20VTE%20for%20breast%20reconstruction
I am considered a complex medical patient with all my health issues...age 70 with a history of developing scar tissue after every surgery I had in my life. The reason I could not have a 2nd child after developing scar tissue in my uterus and fallopian tubes and I was 29 at the time. I had 4 surgeries to correct this and all failed. I never had my much wanted second child.
So, to everyone who is considering implants I would say look at the big picture. I would be high risk if I developed complications post-implants with possible multiple general anesthesia surgeries.
I am a heart patient with a history of a concussion (still paying that price after 6 years) and neurological symptoms. Think twice about implants and all the complications/surgeries you may face.
My decision was absolutely right for me. But everyone is different. Just go into it with eyes wide open.
@triciaot this is so interesting. May I ask how you came upon it? I will share it with both my plastic surgeon and my oncologist. I am taking singular and vit E twice a day (2,000 ) to help with healing. How long a time does one stop the AI to help promote healing?
@wews My reconstruction surgery with gummy bear implants was three months ago and like you my right breast still high. The muscle in that side is very thight. I’m doing OT/PT because cording mostly in my right arm and to relax that side. My plastic surgeon told me to wait until I finish OT/PT to see if that helps. The left implant dropped but I have some scar tissue.
I’ll wait until my next appointment to see what my plastic surgeon says.