Capsular contraction after LD reconstruction

I had a lat dorsi and implant breast reconstruction in Dec 03. I had to have radiotherapy afterwards. However, over the last 5 years the reconstructed breast has become progressively tighter and tighter and the shape is not so good as it was originally. It is okay if i am just standing or sitting but the minute I try to stretch my arm out above my head (eg reaching to a high shelf) it feels quite uncomfortable. I am also having real problems getting a bra to fit (due to the difference in shape between my reconstruction and the other side!) I am going to see the plastic surgeon in July and think I will need to have something done, if it is possible as I am only 44!!

Has anyone had revision surgery for this - ie the tightness/ difference in shape and did it work?

Many thanks!!

Hi Badger

I had Mx, LD flap and implant October 08. It is still very uncomfortable - heavy, almost the feeling of being overfull with milk and has a constant dull ache. I was referred to the surgeon because the front scar was leaking (Dec) and mentioned the heaviness and tightness. After examination I was told this is quite normal, it may get better but for some women the altered sensation may be permanent. I can feel the muscle and implant move around when I raise my arm. It still twitches and/or goes rock hard when I use my arm, this did not seem at all strange to the surgeon who said it is not uncommon.

Hope this helps.


Thanks Jane, I have gone through all sorts of weird sensations - but havent had leaking. The muscle does go hard - particularly when I exercise/lift weights in the gym etc. But this tightness is not due to any of those things.

How easy have you found it to get bras to fit - that match both sides? I am a 32E or F cup - the choice is pretty limited anyway but i need a bra with lots of uplift so the unaffected side can match the reconstruction…


Hi Badger

Almost impossible - the recon is much wider, like a large circle and sort of flatter than the normal side. I find that it sort of invades the other side. So - I am confined to not very flattering sports bras but really need a good underwired to support the weight. The leaking has ruined three good bras - recently discovered the sturdy but unattractive Doreen range and it certainly prvides good support without wires. I feel like my gran in it though.

My bcn said not to do wights - are you sure that is okay? Did you have any nodes removed?

Take care


Hello Jane

I have had about 5 nodes removed. I dont think the BC nurse would say anything about not doing things - I have read about all sorts of things that people say not to do, including scuba diving. (which i have had a go at too!) I dont think there is any evidence that you shouldnt be doing these things? however, my philosphy has been to crack on and do as much as I am able to do. I have been having a go at the weights to try to get a bit of arm strength back up as i now have a noticeable difference in arm strength and being as it is my dominant side that is affected it is really important. Also, the arm on the affected side is really flabby… Why did your nurse say not to do weights?

I had a look at the doreen bra and the size i would probably need isnt there. Also, my implant sits really high, so it would probably be a bit noticeable at the top…

Thanks for your info though.


Hi badger

I had similar problems after my lat dorsi and implant breast reconstruction in Sept 2002, but much more quickly than you. By the end of 2003, the whole breast was very hard and tight and I was having problems moving my arm up - could lift it but not straight up. Had some physiotherapy which helped a bit to get better movement in my shoulder but still had problems. In March 2004 I went in for more surgery and had the implant replaced - the surgeon said there was a lot of thick scar tissue which had formed a capsule around the implant. Since then have had no further problems with the breast (lots of other problems!!) - it continues to have a good shape and to be soft, and I have full movement in my arm.

Hope that helps. Kay

Thanks Kay, that is encouraging. One of the concerns of the plastic surgeon is that if he operates, he might fix it but it could recur. Also, because I had radiotherapy the skin is a bit harder to work with.

I dont think the reconstruction has ever been soft - it always has felt a bit like a firm orange under my skin. Wish it felt a bit softer!!



Hi Both

My recon does try to peep over the top and below the support band (it’s a large, flattish circle) of the Doreen cup whilst not quite filling the front. So far it is the only non - wired bra sturdy enough to keep the weight of the recon up, and it is the weight which is most bothersome to me. I am a 32F on the normal side - probably a D on the other so padding is required…

I am wondering about what you said re exercise Badger as it seems to make more sense than the BCN’s comments. I have been trying to find something that does not “upset” the recon and make it harder so hav not resumed weights. Been sticking to running (even that can make it harden) and not even trying the rowing machine, hence horrible upper body flab. The gym staff were pretty conservative, not having had anyone else with ld recon as a member so no experience of what is safe for me.

Don’t you get fed up with all the conflicting advice? Wish someone would give us an idea - there seems to be no info on this easily sourced.

Kay, that was encouraging.

Also Badger, are you getting a nipple for your recon?

Have a good weekend

Jane x

Hi Badger

Meant to say - the BCN said that lifting weights could trigger lymphodema on the affected side, especially where nodes are removed but even if one only had SNB there is some risk. I did not question the evidence base for this and just assumed there was one. Actually, on reflection I have taken most of what I am told as fact, assuming there is a valid reason for the restriction.

Also, I even find that stretching makes the recon harder ( though it is never soft sometimes the skin is moveable) and the squeezing sensation can become unbearable. That is when it mostly “weeps” clear or slighty bloodstained fluid through the scar.Surgeon looked at this on last visit and said it was nothing to worry about (not pleasant though if damp patches appear on clothes).

Lastly, mine retains imprints of clothes etc even where tey are not tight. Woke this morning with a button indentation from my bedline, still visible 30 mins later!

Don’t know if I want more surgery to fix it but it is very uncomfortable and I am quite limited. BCN said I was lucky to have my recon - lucky me.

Jane x

Jane x

I have had a reconstruction almost 4 weeks ago. and i am experiencing alot of pain in back where taken from and lymph nodes scar and new very hard boob! I am on tramodol parcetomol and naporoxine,which is anti imflamatry tablets like ibuprophen.I know its a while ago but has anyone know of better tablets someone can put you on for the pain, it feels like its burning sensation and tightening up all over areas.booob,back and underarm!

if anyone can help suggest something would be good.I start chemo in almost 2 weeks tac thanks julie

Hi JulieRose

Probably best ot discuss with the BCN or your pharmacist to make sure you are taking the best pills. The sensations you describe are similar to mine and at one point i had an infection which required antibiotics - so get professional advice. Otherwise, and I know you will get sick of hearing this, but it is only 4 weeks so it will feel sore while the body adjusts to the loss and heals itself. I have discomfort even yet and it is almost 6 months. The hardening seems very common, but mention it anyway.

Take Care

Jane x