Breast augmentation remains one of the most popular cosmetic surgeries worldwide, offering beautiful, long-lasting results that boost confidence and enhance body harmony. While most patients heal smoothly, one potential complication that can develop over time is capsular contracture — a tightening of the natural scar tissue around the implant.
Understanding what capsular contracture is, why it occurs, and how it can be treated helps patients feel informed and empowered throughout their aesthetic journey.
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What Is Capsular Contracture?
Any time an implant is placed in the body — whether breast, orthopedic, or dental — the body naturally forms a soft capsule of scar tissue around it.
This capsule is normal and helps keep the implant stable.
Capsular contracture occurs when this scar tissue becomes unusually tight, thick, or firm, causing the breast to feel harder or look distorted.
Contracture can affect either one or both breasts and can develop weeks, months, or even years after surgery.
What Causes Capsular Contracture?
There is no single cause, but research and clinical experience suggest several contributing factors:
Low-grade bacterial contamination (biofilm)
Microscopic bacteria — often from natural skin flora — can form a thin biofilm around the implant, triggering increased inflammation.
Hematoma or seroma
Bleeding or fluid buildup around the implant increases inflammation and scar formation.
Genetic predisposition
Some patients naturally make thicker or more aggressive scar tissue.
Implant rupture or silicone bleed
When the integrity of an implant changes, the surrounding tissue may react.
Smoking or impaired healing
Factors that reduce oxygenation or slow healing may increase risk.
Capsular contracture is not typically caused by patient actions and is often out of anyone’s control. Understanding the risk helps guide early recognition and management.
Symptoms to Watch For
Capsular contracture is typically graded on the Baker Scale (I–IV):
- Grade I: Breast looks and feels soft and natural.
- Grade II: Slight firmness, but normal appearance.
- Grade III: Noticeable firmness and visible change in shape.
- Grade IV: Significant firmness, pain, and distortion of breast shape.
Patients often notice:
- Increased firmness
- Tightness or discomfort
- Change in breast position
- Round or overly spherical appearance
- Implant sits higher on the chest
If you observe any of these changes, an evaluation by a board-certified plastic surgeon helps determine next steps.
Can Capsular Contracture Be Prevented?
While no method eliminates risk completely, surgical technique and post-operative care significantly reduce it.
Surgeons may use:
- Precise, minimal-trauma dissection
- Keller funnel or no-touch insertion
- Proper antibiotic irrigation
- Under-the-muscle placement (when appropriate)
- Textured vs. smooth implant considerations (based on individual case)
Patients can support healing by:
- Following all post-operative instructions
- Avoiding smoking
- Attending routine follow-up appointments
Even with perfect technique and care, capsular contracture can still occur — it is a known complication, not a sign of failure.
Treatment Options
Treatment depends on severity, symptoms, and patient goals.
Nonsurgical Approaches
Generally limited in effectiveness, but may include medications or massage techniques when appropriate. These methods are not typically effective for moderate to severe contracture.
Surgical Options
More definitive treatment often includes:
1. Capsulectomy
Removal of the tightening scar tissue around the implant.
2. Implant Exchange
Replacing the implant with a new device — sometimes switching from over-muscle to under-muscle placement, or smooth to textured, depending on the case.
3. Pocket Change
Creating a new implant pocket to reduce the risk of recurrence.
4. Use of Acellular Dermal Matrix (ADM)
Helps reinforce the pocket and may reduce recurrence in certain patients.
Most patients experience significant improvement in breast appearance, softness, and comfort after proper treatment by an experienced plastic surgeon.
What Results to Expect After Treatment
Once treated, many patients enjoy:
- Softer, more natural-feeling breasts
- Restored symmetry and shape
- Relief from tightness or pain
- Lower recurrence risk with modern techniques
Recovery varies depending on the extent of surgery, but is generally similar to, or even easier than, the initial augmentation recovery.
When to See a Specialist
If you notice firmness, pain, or a change in breast position or shape, it’s best to schedule a consultation. Early assessment helps guide the right path forward and prevents worsening symptoms.
At Dr. Urias Plastic Surgery, we take a thorough, evidence-based approach to diagnosing and managing capsular contracture. Every case is evaluated individually to determine the safest and most effective treatment options.
Interested in an Evaluation for Capsular Contracture in Orange County, CA?
Capsular contracture is one of the best-known — and most treatable — breast implant complications. With proper evaluation and modern surgical techniques, patients can achieve soft, natural, comfortable results and enjoy long-term confidence in their breast aesthetics.
If you’re concerned about changes in your breast implants or want an expert evaluation, our team is here to help. Call Dr. Daniel Urias today at (714) 844-6334 or fill out the online contact form.