For anyone considering breast augmentation, it’s essential to understand capsular contracture—a potential complication that can affect both the aesthetic results and comfort of your breast implants. In this post, Dr. William, a board-certified plastic surgeon, explains what capsular contracture is, what causes it, how to recognize it, and the best ways to treat and prevent it.
What Is Capsular Contracture
Capsular contracture is a condition where scar tissue forms too tightly around a breast implant, causing it to harden, shift, or become misshapen. The body naturally forms a capsule of scar tissue around implants as part of the healing process, but in some cases, that capsule becomes abnormally thick or tight.
Although this condition is one of the most common reasons for breast implant revision surgery, it does not mean your body is rejecting the implant. Breast implants are inert and biocompatible; they don’t trigger rejection like transplanted organs can.
Why the Capsule Forms Around Breast Implants
When a foreign object—like a breast implant—is placed in the body, the immune system creates a protective capsule. This capsule is typically soft and beneficial, keeping the implant securely in place.
However, in about 3–5% of patients, the capsule can become firm and begin to contract, leading to pain, distortion, and changes in breast symmetry.
Common Signs and Symptoms of Capsular Contracture
Knowing what to look for can help you seek early treatment. Here are the most common symptoms:
- Hardness: One or both breasts feel unusually firm
- Shape changes: Breast(s) may appear rounder or misshapen
- Pain or tenderness: Especially with Grade 3 or 4 contracture
- Implant movement: One implant may rise higher than the other
- Visible asymmetry
Causes and Risk Factors
While the exact cause is still being studied, several risk factors can contribute to capsular contracture:
Infection or Biofilm
Even a minor, low-grade infection around the implant can cause the body to isolate the area with excess scar tissue.
Hematomas or Seromas
Fluid or blood collection post-surgery can trigger an exaggerated healing response.
Implant Handling During Surgery
Any contamination during surgery can increase risk—this is why sterile technique is critical.
Genetics
Some individuals naturally produce more scar tissue than others.
Capsular Contracture Grading System
Capsular contracture is categorized using the Baker classification:
- Grade I: Breast feels soft and looks natural
- Grade II: Slight firmness, but still looks normal
- Grade III: Breast is firm and appears abnormal
- Grade IV: Breast is hard, misshapen, and painful—often requiring surgery
Treatment Options
Non-Surgical Treatments (Mild Cases)
- Anti-inflammatory medication to relieve discomfort
- Ultrasound therapy (used in some clinics)
- Breast massage, under the guidance of a surgeon
Surgical Treatments (Moderate to Severe Cases)
- Capsulotomy: Releasing the tight capsule to relieve pressure
- Capsulectomy: Removing the capsule entirely, often with implant replacement
- Fat grafting may be used in some cases to improve softness
👨⚕️ If you’re experiencing symptoms, schedule a consultation with a board-certified plastic surgeon to explore your options.
Preventing Capsular Contracture
While there’s no guaranteed way to prevent it, here are proven methods that reduce your risk:
Implant Placement
Placing implants under the muscle rather than over it significantly lowers the likelihood.
Surgical Technique
A meticulous, sterile technique during surgery greatly minimizes the chance of contamination.
Implant Type
Textured implants were once thought to reduce contracture rates; however, smooth implants are more commonly used today due to updated safety data. Your surgeon will help you choose the best option.
Implant Size Selection
Choosing an implant size that fits your anatomy is key to avoiding tension and complications.
Why Choose Dr. William
Dr. William is a board-certified plastic surgeon with years of experience in breast procedures, helping patients from both South Florida and across the country. Whether you’re planning your first augmentation or exploring a breast revision surgery, Dr. William tailors every procedure to your unique goals and anatomy.
📍 In-person consultations available in South Florida
💻 Virtual consultations available for out-of-town patients
🌐 Schedule your consultation at drwilliammiami.com
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Final Thoughts
Capsular contracture is a manageable and treatable condition, especially when diagnosed early. If you’re experiencing changes in your breast implants—or planning a future augmentation—understanding the risks and how to prevent them is key to your long-term satisfaction and safety.
Your journey to confidence starts with the right information and the right surgeon.
