What causes the implant contracture to start aching a little?

What causes the implant contracture to start aching a little? I was actually told by my doctor not to do anything until I had to. I've seen a surgeon.

Doctor Answers 7

Capsular Contracture Discomfort

Capsular contracture is the abnormal tightening of scar tissue around an implant. In more severe cases (grade 3) this causes physical distortion of the breast. If things worsen more (grade 4), the tightness can start to cause discomfort as well. Mild capsular contracture can be left alone, but if the problem is starting to cause discomfort from tightness and pressure on the nerves and soft tissue, you should consider having a revision. This would normally entail removing the implant and all of the scar tissue, replacing the implant with a new one, washing the pocket with antibiotics, and possibly using an acellular dermal matrix like Strattice to reduce the risk of a recurrence.


Santa Monica Plastic Surgeon
5.0 out of 5 stars 40 reviews

Pain and contracture

Thanks for your inquiry. The pain is from the tightening of the tissues and the pressure it places on the surrounding breast.  I am glad you are seeing a surgeon to evaluate why this happening.  Good Luck.  

What causes the implant contracture to start aching a little?

The first question I'm always curious about is - why do you have a capsular contracture to begin with? Obviously the contracting of the capsule causes the pain as it tightens, however the cause of the contracture can lead to correcting it and preventing another one. Contractures  are secondary to inflammation of the capsule. The inflammation can be caused by a number of factors - bacterial colonization, smoking, hematomas, etc., although the entire process of capsular contracture is not completely understood. Your surgeon will probably recommend non-surgical approaches initially, only proceeding after those prove unsuccessful.

Contracture Ache

The contracture ache comes from the tightening of the space around the implant. This usually causes the breast to start feeling hard and tight.

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 6 reviews

Capsular contracture

As the capsule around the implant is getting tighter, it can cause pain. A normal capsule is soft and thin, and not painful. If capsular contractures are caught early enough, sometimes they are treatable with non-surgical options such as increasing oral Vitamin E consumption daily, increasing massage, and medications such as Singulair, and Minocycline. There is also a treatment called ASPEN which is a high powered ultrasound treatment and/or treatments specifically designed to treat capsular contractures. Hope this help. Best of Luck!

M. Bradley Calobrace, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 39 reviews

What causes aching in capsular contracture

 It's my opinion that the aching feeling you're describing is because of the pulling sensation of the tightening capsule on the surrounding tissues. When caught early, we've had good success treating with vitamin E, a pill called accolate, and a new technique called Z wave which uses acoustic sound waves to bombard the capsule causing it to stretch. In established capsules for long periods of time, removal of the capsule and replacement with Strattice has been very successful in my practice, Good luck

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

What causes the implant contracture to start aching a little?

Capsular Contracture The hallmark of contracture is one breast becoming firm and moving up towards your collarbone causing the nipple to rotate downward and can even be painful. Capsular Contracture is not well understood, and a single cause has not been identified. Leading theories include: subclinical venous bleed, low level bacterial contamination and/or biofilm, lint contamination from sterile drapes and genetic predisposition. Since the cause is unknown, treatment typically involves addressing all possible causes. There are four grades of contracture. Grade I is normal, looks good and feels soft and does not require treatment. Grade II feels firm but otherwise looks good. Grade III feels firm and looks distorted at rest. Grade IV feels firm, looks distorted at rest and is painful. Aggressive massage +/- Leukotriene Inhibitors can improve/soften Grade II contracture but in my experience it rarely improves the superior malposition present in Grade III and Grade IV contracture. These respond best to surgical revision/capsulectomy and implant exchange.

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.