Capsular Contracture vs. Bottoming Out

[imnyc]

Hi Dr. Rosenberg,

My ps is about to perform a capsulorraphy on me for my bottomed out revision using PDS sutures only to 'lift' the pocket up and hope that scar tissues will build up and help create a newly formed crease.

Since my breast is already harder than the other side and have had more surgeries, I am concerned about capsular contracture.  I heard taking Vitamin E and other supplements such as the following (Scar Multiplex Formula) would help:

http://www.smhomeopathic.com/store/product898.html

I won't be taking any Vitamin E at least until a few weeks post-op, however planned to take other supplements to help prevent CC.

The concern is - since we are expecting scar tissues to build around the sutures while healing... will taking these supplements to supposingly soften scar and get rid of 'excess' scar tissues 'counteract' the bottomed out revision healing process? i.e. -

Will the bottomed out revision NOT work (since no capsules will be rolled up, but my ps is only using slowly dissolving sutures to help create scar tissues) if I take supplements to prevent capsular contracture?

Any insights would be appreciated.

Thank you again

[Howard Rosenberg, MD]

The product you describe is being marketed for profit by a pharmacy.  I know of no peer reviewed double blind scientific published studies that support the use of these products and their claimed effect.  Capsule contracture is a complex issue that is not fully understood.  If any oral supplement was documented to be effective,  every plastic surgeon would use it.  

If your bottomed out breast requires a capulorraphy yet the implant demonstrates some degree of existing capsule contracture, then treatment would require release or excision of the capsule in its superior position, along with shoring of the capsule inferiorly to treat the problem.  You want the superior aspect of the capsule to remain widely open and the inferior correction to heal and keep the breast elevated.  No pill will assure either will occur.

[imnyc]

Thank you again Dr. Rosenberg.  Your detailed response is really helpful.  Much appreciated.