Capsular contracture

Capsular contracture 

Capsular contracture is a potential complication that can occur after breast implant surgery. It refers to the abnormal tightening or hardening of the scar tissue capsule that naturally forms around the breast implant. This scar tissue, known as the capsule, is the body’s natural response to a foreign object, such as a breast implant.

In a normal healing process, the scar tissue capsule remains thin and flexible, allowing the breast implant to move naturally and feel soft to the touch. However, in cases of capsular contracture, the capsule becomes thickened, tight, and can compress the breast implant, leading to various degrees of firmness, distortion, and discomfort.

Symptoms of capsular contracture

It’s important to note that the severity of symptoms can vary from person to person, and not all individuals with capsular contracture will experience all of these symptoms. If you suspect capsular contracture or are experiencing changes in your breast appearance or discomfort, please book a scan for a thorough evaluation and appropriate management.

The symptoms of capsular contracture can vary in severity and may develop gradually over time. The most common symptoms of capsular contracture include:

Breast Firmness

One of the earliest signs of capsular contracture is an increase in breast firmness. The affected breast may feel harder or less pliable compared to the unaffected breast. In some cases, the breast may become excessively firm, creating an unnatural appearance.

Breast Shape Distortion

As the scar tissue capsule contracts and tightens around the breast implant, it can cause the breast to appear misshapen or distorted. This can include changes in the implant position, visible rippling, or an irregular breast contour.

Breast Pain or Discomfort

Capsular contracture can be accompanied by localized pain or discomfort in the affected breast. The pain may be constant or intermittent, and it can range from mild to severe.

Changes in Breast Sensation

Some individuals with capsular contracture may experience changes in breast sensation. This can manifest as increased sensitivity, decreased sensation, or altered feelings in the breast and nipple area.

Visible Rippling or Wrinkling

In cases of severe capsular contracture, the scar tissue capsule may compress the implant, leading to visible rippling or wrinkling of the overlying skin. This can create an unnatural or rippled appearance.

What causes capsular contracture?

The exact cause of capsular contracture is not fully understood. However, a variety of factors have been identified that may contribute to its development. These include:

Biofilm Formation

It is believed that the presence of bacterial biofilm on the surface of the breast implant can trigger an inflammatory response, leading to the formation of a thicker and more contractile capsule. Biofilm is a colony of bacteria that can develop on the implant surface, although the exact relationship between biofilm and capsular contracture is still being studied.

Immunological Response

The body’s immune system recognizes the breast implant as a foreign object and forms a scar tissue capsule around it. In some individuals, the immune response may be more pronounced or abnormal, leading to the development of a thicker and tighter capsule.

Surgical Technique

Factors related to the surgical procedure itself can influence the risk of capsular contracture. These include improper implant placement, trauma or bleeding during surgery, contamination of the surgical site, or inadequate tissue coverage over the implant.

Implant Characteristics

The type and characteristics of the breast implant can play a role in the development of capsular contracture. Textured implants, which have a rough or textured surface, have been associated with a higher risk compared to smooth implants. The exact mechanisms by which textured implants increase the risk of contracture are not fully understood.

Genetic Predisposition

Some individuals may have a genetic predisposition to develop a more pronounced immune response or abnormal scarring, which can increase the risk of capsular contracture.

It’s important to note that while these factors have been identified as potential contributors to capsular contracture, the condition can still occur without any identifiable cause. Researchers are continuing to investigate the complex factors involved in capsular contracture to better understand its development and prevention.

How is capsular contracture diagnosed?

Diagnosing capsular contracture typically involves a combination of clinical evaluation and imaging studies. If you suspect capsular contracture or are experiencing symptoms such as breast firmness, shape distortion, or discomfort, please book a breast implant health check, for a thorough evaluation. Here are some common diagnostic methods used to assess capsular contracture:

Physical Examination:

The plastic surgeon will perform a physical examination of your breasts to assess their appearance, texture, and symmetry. They will evaluate the degree of breast firmness, check for any visible distortion, and assess the overall condition of the breast implants.

Baker Classification:

The Baker classification system is commonly used to grade the severity of capsular contracture. It categorizes capsular contracture into four grades:

  • Grade I: The breast appears natural and soft.
  • Grade II: The breast feels slightly firm but looks normal.
  • Grade III: The breast is noticeably firm and may have visible distortion.
  • Grade IV: The breast is hard, painful, and significantly distorted.

This classification helps in assessing the severity of the condition and guiding treatment decisions.

Imaging Studies:

In some cases, imaging studies may be used to evaluate the extent of capsular contracture and rule out other potential causes. These may include:


A mammogram is an X-ray of the breast tissue. While it primarily screens for breast cancer, it can also help identify changes in the breast implant position or detect abnormalities associated with capsular contracture.


Ultrasound imaging uses sound waves to create detailed images of the breast tissue. It can help visualize the thickness of the scar tissue capsule, detect fluid collections, and assess the overall condition of the breast implants.

MRI (Magnetic Resonance Imaging):

MRI provides more detailed images of the breast and can be particularly helpful in assessing the extent of capsular contracture, detecting implant rupture, and evaluating the surrounding breast tissue.

These diagnostic methods help us assess the presence and severity of capsular contracture. Based on the evaluation, we can develop an appropriate treatment plan tailored to your specific needs.

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