Can CC go 'away'...

[cdnsarx3]

on it's own? If so, how does scar tissue just go away?
Also, can someone have grade II CC and it never get worse?
Thanks

[Nikki]

Not usually. Accolate can sometimes help, but most people require surgery. I've had it twice. Do you have cc?

[Jess]

Originally Posted by Nikki

Not usually. Accolate can sometimes help, but most people require surgery. I've had it twice. Do you have cc?

Nikki, what grade did you have and did you start out low and it got worse?

I have grade II and my PS doesn't think it will get worse but he cant say for sure. If it does and I have surgery he wants to give me textured silicone, partial unders (he wants to keep me on partials).

When you had CC did you know it? I had no clue and I still don't see or feel what he does. It's so weird.

[cdnsarx3]

Originally Posted by Nikki

Not usually. Accolate can sometimes help, but most people require surgery. I've had it twice. Do you have cc?

I'm pretty sure I do, but it has yet to be confirmed. I see my PS next week

[jess123]

i found this interesting... take as u will ..a single study done... Introduction: Significant capsular contracture (Baker Class III or IV), occurring at a rate of 4.6-25% in submuscular saline breast augmentation(1), presents a formidable challenge to the plastic surgeon. Certainly, the recent use of the leukotriene antagonist zafirlukast (Accolate; AstraZeneca, Wayne, PA) for contracture reversal has received much attention in the popular media. However, validation of its effectiveness rests only on limited case series and anecdotal reports(2,3). To this end, a single surgeon’s experience using Accolate in the treatment of capsular contracture in primary, submuscular augmentation with saline smooth –walled implants is presented.
Methods: From the period of January 2002 to January 2003, the senior author performed 49 bilateral submuscular augmentation mammaplasties with saline smooth-walled breast implants (98 breasts). All patients were placed on the same postoperative protocol, which included early implant mobility (massaging) and vitamin E 400 I.U. orally twice daily at 4 weeks. A prospective analysis of the effects of Accolate on early capsular contracture was carried out in the following manner. Patients were regularly evaluated in the office by the operating and clinical staff (2 independent observers) and rated for capsular contracture using a modification of the Baker classification(4). We define contracture as follows: Class 1=breast absolutely natural, augmentation undetectable; Class 1.5=breast soft, but implant is detectable by physical examination; Class 2=mild firmness, prosthesis not detectable by examiner or patient; Class 2.5= mild firmness and implant detectable by examiner but not patient; Class 3=breast moderately firm and detectable by patient; Class 4=severe firmness, obvious from observation, with pain. Patients who demonstrated any capsular contracture (>=1.5) were given Accolate 20mg orally twice daily and assessed at 3- and 6-month timepoints for any change in contracture. The endpoint of this study was 6 months or a return to a Class 1 capsular score. One patient failed to complete the study.
Results: Using our modification, 52 of the total 98 breasts had no capsular contracture and thus were rated Class 1 (53%). 45 breasts (46.0%) were found to have early, mild capsular contracture: of this group 28 breasts were Class 1.5 (28.6%), 16 breasts were Class 2.0 (16.3%), and 1 breast was Class 2.5 (1.02%). In this series only one breast demonstrated moderate capsular contracture (Class 3) (1.02%). Of these 46 breasts, 32 mildly contracted breasts Class 1.5 or greater have completed the protocol. Responses were scored as either complete (return to Class 1), partial (reduction in capsular contracture index by 0.5), or nil (modified Baker class the same or worse despite therapy). Mean follow-up was 6.3 months. After an average of 4.8 months of treatment, 14 out of 32 breasts (43.75%) demonstrated a complete response to Accolate therapy, whereas 9 of 32 (28.1%) demonstrated a partial response to the leukotriene antagonist. The remaining 9 of 32 (28.1%) had no response to therapy, either staying the same grade or worsening. Therefore, a positive response (complete or partial) was seen in a statistically significant proportion of treated breasts (71.875%; p<.001).
Conclusions: Our initial results support the effectiveness of Accolate in early capsular contracture after submuscular saline smooth augmentation mammaplasty. Further follow-up will demonstrate its long-term effects.

View Synopsis (.doc format, 27.0 kb)
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[4x4gal]

Originally Posted by Jess

When you had CC did you know it? I had no clue and I still don't see or feel what he does. It's so weird.

I know you're asking Nikki, but I figured I would tell you how I caught mine...I was able to notice a slight firmness on the upper half inside area of my left breast. My right one felt pretty "real." I have silicone overs, and I just knew something was a bit different on the left. However, if both of them developed CC at the same time, then I probably wouldn't have noticed. It helped having one good breast to compare it to. Also, there was a slight discomfort when I was massaging my left one. Sorry to hear you have CC. Did you PS put you on Accolate?

[Jess]

Originally Posted by 4x4gal

I know you're asking Nikki, but I figured I would tell you how I caught mine...I was able to notice a slight firmness on the upper half inside area of my left breast. My right one felt pretty "real." I have silicone overs, and I just knew something was a bit different on the left. However, if both of them developed CC at the same time, then I probably wouldn't have noticed. It helped having one good breast to compare it to. Also, there was a slight discomfort when I was massaging my left one. Sorry to hear you have CC. Did you PS put you on Accolate?

he isn't doing anything for it b/c it's mild. Honestly the only thing I have from it is discomfort if my boobs are "used" a lot. They get sore easily and stay sore if I over do things. Sucks. I hate that part b/c my hubby likes to touch and play with them (just being playful, like in passing) and most of the time I'm like "owwww" or "be careful!" Ugh. Like right now, they are sore. They aren't hard or anything, very soft and jiggly except for a spot around my areola, it feels firms and has always felt firm.

[Nikki]

Originally Posted by Jess

Nikki, what grade did you have and did you start out low and it got worse?

I have grade II and my PS doesn't think it will get worse but he cant say for sure. If it does and I have surgery he wants to give me textured silicone, partial unders (he wants to keep me on partials).

When you had CC did you know it? I had no clue and I still don't see or feel what he does. It's so weird.

I had grade III/borderline IV. I started out even, then my right implant slowly moved farther and farther up on my chest. By 6 months post-op, my implant was REALLY HIGH. This happened TWICE.

Sometimes cc won't get worse (seems like it does most of the time tho). Is it possible that your ps didn't make your pocket large enough, or made it a little differently than your other pocket?

I personally don't think I'd want to switch to textured, but that's just me. I've had 4 breast surgeries, and twice I had cc. I've ALWAYS had smooth implants tho.

I was reading in the Aesthetic Surgery Journal that there is a such thing as biofilm on implants. Even sanitizing implants in antibiotics, etc. cannot kill all of the bacteria (if any is on the shell). Here's part of that article:

"It is now clear that bacteria exist in two distinct phases, a free-floating or planktonic form and a more common sessile form that adheres onto solid surfaces by means of a secreted exopolysaccharide or biofilm. In addition, they have been implicated as a cause of chronic antibiotic-resistant and culture-negative inflammation in endotracheal tubes, biliary stents, prosthetic joints, and urinary tract sepsis, as well as corneal ulceration from contact lens contamination. No inert surface is immune to the establishment of bacterial biofilms. In biologic systems, the presence of body fluids and proteins further encourages their formation. In medical device-related infections, biofilms have been shown to be resistant to even the highest concentrations of disinfectants, surfactants, heavy metals and antibiotics. The structure and function of biofilms, as well as the molecular mechanisms for their establishment and maintenance, are the subject of much current research. The prevention and treatment of biofilm disease is also the subject of intensive investigation."

The above paragraph is why I would always opt for a new implant when you have a cc repair surgery.

As for textured implants, I think they do help reduce cc risks in women w/OVER the muscle implants. From what I've read, the risk with smooth vs. textured is about the same in women w/under the muscle implants.

When I had my first capsulectomy, my ps sterilized my implant, and reinserted it after doing the capsulectomy. I got cc again on that same side. WHen I had my first redo, I got a new set of implants - and no cc. When I had my redo, I got a new set of implants - again, no cc.

[Nikki]

Originally Posted by Jess

he isn't doing anything for it b/c it's mild. Honestly the only thing I have from it is discomfort if my boobs are "used" a lot. They get sore easily and stay sore if I over do things. Sucks. I hate that part b/c my hubby likes to touch and play with them (just being playful, like in passing) and most of the time I'm like "owwww" or "be careful!" Ugh. Like right now, they are sore. They aren't hard or anything, very soft and jiggly except for a spot around my areola, it feels firms and has always felt firm.

If your ps is certain that you're getting cc, you should try the Accolate NOW. The SOONER you start it, the higher the success rate. Don't wait until your cc gets really bad, b/c at that point, Accolate may be useless.

[Jess]

Originally Posted by Nikki

If your ps is certain that you're getting cc, you should try the Accolate NOW. The SOONER you start it, the higher the success rate. Don't wait until your cc gets really bad, b/c at that point, Accolate may be useless.

Can you have it w/o having a "high" breast? Both of mine look the same and they both sit low (I just added my 12 month pics to my group) but to me I dont look to have it. I asked him about "doing" something for the CC and he told me no, I dont need anything. He wants to give me textured for more upper fullness and more perkiness...

All I know is if I continue to have sore breast all the time I will need to do something. ANY type of endurance makes me sore for days.

[4x4gal]

Originally Posted by Jess

Can you have it w/o having a "high" breast?

My breast is NOT higher than the other one. The pretty much look the same. However, the left one is just a bit firmer and a little sore at times. I'm on accolate, and my fiance thinks it is helping a bit, but Im not sure.

[Nikki]

No, the implant doesn't have to be high on the chest in order to have cc. The problem with me is that the lower and outer side of the pocket wanted to close in. So when it did, the implant moved upward. But that's not always the case.

I didn't have any trouble with soreness or pain until my cc became grade III/IV. At that point, there was a lot of soreness. You usually don't get soreness/pain until the late stages of cc.

PM the link to your group.

[Jess]

Originally Posted by 4x4gal

My breast is NOT higher than the other one. The pretty much look the same. However, the left one is just a bit firmer and a little sore at times. I'm on accolate, and my fiance thinks it is helping a bit, but Im not sure.

Mine go off and on with being sore. Honestly I'm getting real sick and tired of it, heh. I have boobs and they look good but I cant take them being sore most of the time.

[Jess]

Originally Posted by Nikki

No, the implant doesn't have to be high on the chest in order to have cc. The problem with me is that the lower and outer side of the pocket wanted to close in. So when it did, the implant moved upward. But that's not always the case.

I didn't have any trouble with soreness or pain until my cc became grade III/IV. At that point, there was a lot of soreness. You usually don't get soreness/pain until the late stages of cc.

PM the link to your group.

The soreness I have is the upper part of my breast (above the areola and sides above the areola). Just real sore to the touch sometimes. I hate it b/c it will last for days and then go away and then come back again. I dont get it.

[Nikki]

Jess, I just looked at your pics, and you don't look like you have cc to me at all. I cannot see how cc would be causing you pain at this point. It's not even noticeable.

PMing you.