If you have capsular contracture, how long can you wait before you have to get something done?

It's very unlikely to have significant capsular contracture before six months. Once established there's no particular window of opportunity so treatment can be started pretty much any time.

Capsules form in every breast implant patient to some degree.  As long as the capsule is soft and pliable, you will probably never know it is there.  On the other end of the spectrum, if the capsule becomes thicker, it can cause the breast to become firm and/or distort the appearance of the breast.  The capsules are not dangerous.  They are simply scar tissue forming around the implants.  It is only when the capsule becomes an issue for you that it is an issue at all.  You can wait as long as you want to to do anything about it if necessary.

The term "Capsular Contracture" refers to a tight, firm scar that forms around a breast implant shortly after surgery. The reason that this occurs is that a breast implant is seen by your immune system as a foreign object that has to be controlled. This is a natural response that occurs in every patient whenever a foreign body is present (for example an abscess is an infection that is surrounded by a scar capsule to limit the infection from spreading). Most of the time the scar capsule is thin, and this is because the immune system does not see the breast implant as too dangerous an object. However, in some patients the immune response is aggressive and a tight capsule results.Because the implant is present there is a limit to the extent of the tightness that can occur. Generally the Capsular Contracture will reach a point where it will stabilize, and this is the point when treatment is most effective. Most scar contractures occur in the first 6 weeks after the initial surgery, but we often wait for 3-6 months to allow the scar to stabilize. Interestingly, in 50% of patients who have the contracted, tight scar capsule removed at a second surgery the scar contracture does not return, even though the same implant is replaced and the patient's immune system is obviously the same. There is a lot that we do not understand when it comes to Capsular Contractures, and hopefully we will develop techniques or implants that decrease the chances of this occurring.

Treatment depends on how much it bothers you.  In severe cases distortion and pain usually drive the patient to have surgery.  Some patients have significant capsules for years and do no seek treatment.  Donald R. Nunn MD   Atlanta Plastic Surgeon