Capsular contracture following implant surgery

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

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.

@wews sometimes when I research/Google for some answers, I just take a “stab in the dark” and see what comes up. Capsular contracture is a type of scarring, and I noticed you said you’re on an AI. I’ve have/had issues with scar, and or cell necrosis, since my breast conserving lumpectomy. My right breast didn’t drop into place (although I don’t have an insert) to match my left side. There are other issues involved but I was thinking about whether lack of estrogen affects scarring and/or healing. I am on tamoxifen.
So I googled capsular contracture, aromatase inhibitor, and low estrogen - I just put in the three terms and see what comes up.

I’ve found the more specific words I use the better the results. I also try to throw in some typical medical terms that better define what I’m looking for - the search then looks for these words which are often used in research.
Correlated, Contraindicated, Prognosis, Disease free intervals, Subclinical, Associated with, Causation, etc.

More recently I’ve found that if I pose a detailed question, the built in AI support in the search engine tries to problem solve my issue. It comes up with a variety of solutions. I always check the sources it used. I toss out answers from dubious sites - although I sometimes take that answer and see what Mayo Clinic or Cleveland Clinic or Harvard has to say on the topic to verify the value of that response.

I chose to stay flat because I’ve always had a problem with scar tissue and didn’t want additional surgeries.

I totally get that and if I continue to have a problem I will probably choose to do that too. I never had any problem with scar tissue before so I had no idea these things happened with implants.

Was that surgery difficult too?

@fronterae did you have a mastectomy ?

@christylv Yes I did a risk reduction mastectomy in July.

I had a bilateral mastectomy in February.