What are the signs and symptoms of Capsular contracture? What should I watch out for after my breast aug/lift?

I know what CC looks like and how the scars form, but I'm more interested in early detection. What should I watch out for? What do the early stages feel like?

Doctor Answers 9

Signs of capsular contracture

Thank you for your question.  The signs of early capsular contracture are often increasing firmness of the breast.  Occasionally some patients can notice some early discomfort in the breast.  As the capsular contracture gets tighter, the implant and breast shape can change.  Unfortunately early detection doesn't impact management much since there is really no treatment other than surgical with scar tissue removal and replacement with a new implant.  

Salt Lake City Plastic Surgeon
5.0 out of 5 stars 34 reviews

What are the signs and symptoms of Capsular contracture?

This is a great question. Capsular contracture is the process where the capsule that forms around an implant becomes hardened and contracted or it squeezes tight around the implant. We do not know why it happens but do have a few solid theories. One theory is that blood in the pocket leads to irritation of the capsule and stimulates a contracture. This process is less though of compared to the biofilm theory. This theory implies that bacteria live in the breast pocket not enough to cause an infection but cause enough irritation in the breast pocket that the overlying capsule can begin to contract. This theory makes sense because we see higher contracture rates in patients who have had a breast implant infection. So the thinks you should look for over time are a tender hard breast that will begin to pull on the overlying breast tissue and distort the shape. Fortunately it is rare and you most likely will not have to worry about it, but that is the main thing to look for. Hardening of the breast that may or may not initially be painful and eventual distortion of breast shape. 
Please read my blog below to understand what causes capsular contracture.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Capsular contractures


Thanks you for hour question. Any foreign material in the body is walled off by the body with a capsule, be it a breast implant or a joint. This capsule is formed of collagen and some contractile cells. Whilst there are various theories about the pathogenesis of capsular contractures it is thought that clinically evident capsular contractures are due to either a subclinical infection of this capsule/implant interface or inflammatory process due to postoperative bleeding. 

So with this as background, here are some helpful tips, the vast majority of the capsular contractures happen in the first year. Where they are clinically significant (they are graded by Baker from soft/normal as grade 1, rock hard and painful as grade 4), they will require surgery and exchange ion order to rectify this. 

The best thing you could watch out for is hardness and/or pain. I hope this helps, good luc

Ross Farhadieh, MBBS, MD, FRACS, FRCS
Sydney Plastic Surgeon
5.0 out of 5 stars 11 reviews

Signs of capsular contracture

Thank you for question.  Early in the capsular contracture formation, you may notice some firmness in one part of one breast or maybe even the entire breast.  As the contracture progresses, it can cause shape changes to the affected breast and finally, it can even cause pain and discomfort.  If you are experiencing any of these, I would return to your plastic surgeon who can examine you and help guide you through your options.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Early Detection of Capsular Contracture

That's a great question dealing with one of the most perplexing issues involving any plastic surgery....how to detect and prevent the "normal" scar tissue from developing into "abnormal", or hard scar tissue.
To address your question specifically, there is no scientific "early detection" model.  If you have non textured implants that you exercise daily, watch (feel) for subtle changes in softness of your breasts when you do the squeeze exercises.  The first sign is almost always a slight, new firmness in the implant.  This is often associated with occasional vague pains that you hadn't experienced before.  Sometime the pains come first, so watch for that.  
The importance of early detections is that there are medications that sometimes arrest or minimize the impact of the scar tissue and the sooner they are instituted, the more likely they are to help keep your breasts soft.  I hope this helps.

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 39 reviews

Capsular Contracture

Everyone develops scar tissue after breast augmentation. Normally people begin to feel the breast becoming firmer and then if the scar tissue continues to progress you can see it.  Best way to prevent it is with massage.

Arthur M. Cambeiro, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 181 reviews

Signs and symptoms of capsular contracture

Hi, Teebundle.  Thanks for your question.  Capsular contracture has 4 degrees of severity.  Grade I has normal appearance and normal feel.  Grade II has normal appearance but slightly firmer feel that you can appreciate.  Grade III has abnormal appearance (deformity that give asymmetry) and firmness.  Grade IV has grade III plus pain.  Most patients will notice grade II capsular contracture.  I recommend implant exchange and capsulectomy if the patient has grade III/IV.  Hope this helps.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

What are the signs and symptoms of Capsular contracture? What should I watch out for after my breast aug/lift?

Thank you for your question.  Capsular contracture is rated along a 4 point severity scale termed the Baker classification or grades.  Type I contracture is basically a normal breast, no abnormality can be seen or felt with your breasts 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.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Signs and symptoms of CC

Although capsular contractures following breast augmentation can occur just about any time, most women start having symptoms around three months after their breast implant surgery. This is because it takes some time for a capsule to form and then to scar down (contracture).
Capsular Contracture is a condition in which the capsule surrounding the implant thickens and contracts, squeezing the implant making it overly firm or hard and often changing the shape and position of the implant. As the capsule contracts it moves the implant further up your chest wall making upper portion of your breast too large and unshapely. It is more far more common in nicotine users (e.g. smoking, vaping or nicotine gum or patches).

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 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.