Capsular contracture is the most common problem associated with breast augmentation. Capsular contracture occurs when naturally forming scar tissue around the implant shrinks and tightens, making the breast feel firmer than normal and sometimes causing pain and an unnatural appearance of the breast.
Any implant, breast implants included, stimulates the body to form a capsule around it that is comprised of collagen fibers and some cells. It is thought that some cells, called myofibroblasts, act like muscle cells and can contract or shorten. When this happens, the capsule surround the implant shrinks. If carried to its extreme, it would shrink to a point (i.e. collapse). As it shrinks around the implant, the contents of the capsule increases in pressure just as if you were to squeeze your hands around a balloon. The more you squeeze, the higher the pressure.
If the capsule is the same size or larger than the implant, then the pressure is the intrinsic pressure of whatever is in the capsule. A saline implants has higher pressure when filled to maximum than the silicone gel so the silicone gel impants is softer.
Surgeons become concerned with capsular contracture of grade 3 or 4.
- Grade 1 is when the implant is soft and the shape is normal
- Grade 2 is when you can feel the implant but it doesn't distort the breast
- Grade 3 is when the implant feels firm and distorts the shape of the breast
- Grade 4 is when it is firm and causes pain