What is a capsular contracture? Or what does one look like? I don't think I have one, just curious.

Doctor Answers 7

What is a capsular contracture? Or what does one look like? I don't think I have one, just curious.

Thank you for your question.  Capsular contracture is a hardening/tightening of the scar tissue that forms around all breast implants and is rated along a 4 point severity scale termed the Baker classification.  Type I contracture is basically a normal breast, no abnormality can be seen or felt with your breast or implant.  Type II contracture demonstrates a thickening, hardening, or firmness of your implant that can only be identified by feel.  Type III contracture can be both felt, as well as seen as a visible distortion to the breast.  Lastly, Type IV can be felt, seen, and painful.  Hope this helps.

Atlanta Plastic Surgeon
4.9 out of 5 stars 69 reviews

Capsular Contracture

Hello and thank you for your question. Capsular contracture is probably the most challenging problem we encounter with breast augmentation.  The cause is secondary to thickening of the usual thin layer of scar tissue (capsule) that develops after the implant is placed.  Although we are not sure what causes the thickening most of the time, we do know that blood that accumulates around the implant or a small amount of bacteria (biofilm) can definitely cause it.  It is extremely critical that your surgeon and his operating room have a lot of experience in sterile technique and almost completely eliminate any blood loss.  The usual amount of blood loss during a breast augmentation in our facility is basically zero.  Per your question, the capsular contracture rate varies widely depending on which surgeon is performing the procedure and what type of implants and what kind of patients (cosmetic or breast reconstruction).  Most studies for smooth silicone cosmetic implants demonstrate a capsular contracture rate about 5-8% with textured implant rate a little less.  If capsular contracture does occur, several steps can help to resolve the issue.  A lot of surgeons use a product like Accolate or Singular which impairs the inflammatory cascade that causes the thickening.  I have had great success with this medicine.  If the implants remain hard, then a capsular release or capsule removal has to be done with surgery.  This always eliminates the problem but on rare occasion the same thickening can occur.

Gregory DeLange, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 56 reviews

Capsular Contracture Explanation

Dear sreddy91,

Any time an artificial manmade device is placed in the body whether it be a breast implant, a pacemaker or an artificial joint, your body will form a layer of tissue around it called the capsule. That is your own tissue. Sometimes that tissue can start to contract down, and then the normal dome-shaped implant gets drawn higher up on the chest and assumes a more spherical look. It can actually get to the point where it is harder and painful. There are many things a surgeon can include in his or her technique to lower the incidence of that. In addition, the incision under the breast as well as position of the implant underneath the pectoralis major muscle yields a lower contracture rate.

Most recently a newer so-called structured saline implant called the Ideal implant is found at six years’ time to have the lowest capsular contracture rate.

I hope this has been helpful.

Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

Capsular contracture

A capsular contracture usually presents as a firm or distorted breast that contains an implant. It can be painful. Treatment is removing the capsule and implants, and exchanging with a new implant.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

What is a capsular contracture? Or what does one look like? I don't think I have one, just curious.

A capsular contracture occurs when scar tissue around the breast implant, called a capsule, contracts and tightens around the breast implant.  The restriction of movement caused by the tight capsule can cause pain and makes the breast feel very hard.  There are 4 grades of capsular contracture.  Grade 3 and 4 usually require surgical removal of the capsule and implant, replacement of the implant and wrapping of the implant with a membrane called acellular dermal matrix.

Capsular contracture

Capsular contracture is a thickening and hardening of scar tissue around a breast implant. It can increase in severity over time and in severe cases can be associated with deformity and pain in the affected breast. It can be treated surgically with release or removal of the scar tissue and adjustment or replacement of the implant.

Salem Samra, MD
Middletown Plastic Surgeon
5.0 out of 5 stars 3 reviews

Capsular Contracture

Thanks for your question! Capsular contracture is a condition where the scar capsule around the breast implant gets thickened and hardened, causing firmness, visible difference and asymmetry, and even pain. There are different grades of contracture, and although they can sometimes be resolved through non-operative means, they may require surgery. Some studies put rates of contracture as high as 20%, and it is more common in smokers. 

I've found that in my experience of doing thousands of implant surgeries, implant massage (I start at 3 weeks post op) really helps to prevent this condition. Best of luck to you! 

Robert P. Schmid, MD
Lubbock Plastic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.