Capsular contracture: does the risk increase the longer you have implants?

Hi! I am a 46 year old very fit woman considering getting implants for my 32A breasts. I have read that capsular contracture rates are currently very low (some PS report their rates are at 1%), but I am wondering if that rating is for the first year, and that the risk increases the longer implants are in the body. Basically, I am wondering if, similar to rupture risks (1% increase every year), the risk of capsular contracture also increases in a similar fashion. Thank you!

Doctor Answers 7

Breast implants and Capsular contracture

Capsular contracture can occur early or late in the postoperative period.

Early capsular contracture within the first 2 years after surgery may result from extra scar tissue forming possibly from trauma, infection, foreign body reaction, fluid, blood, etiology unknown, etc.

Late capsular contracture can develop decades after surgery. Late capsular contracture may be attributed to ruptured silicone implants or silicone gel leaking; radiologic studies are helpful.

For severe capsular contracture (grade 3 and 4), surgery is performed to improve symptoms and aesthetic results.

Capsular contracture of breast implants: does the risk increase the longer you have implants?

Thank you for your question.  As others have stated there is a lifetime risk of capsular contracture however in my experience, the risk is higher in the first 2 years after breast augmentation.  I encouraged my patients to continue their breast implant displacement exercises for life to hopefully keep the breast implant pocket large.

Capsular contracture

I think that there is a lifetime risk of capsular contractures that have been quoted in the range of 5-15%.  It is most common in the first few years after surgery.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Capsular contracture rates

The statistics for this problem are variable depending on the source, but in our experience the likelihood of contracture appearing is highest in the first 18 months, with prevalence slowly increasing over time.  By analogy, the risk of a driver having a car accident is greatest in the first two years of driving, but some risk of it occurring remains even 20 years later. I would not compare it to the risk of saline implant rupture, as this risk increases with the age of the implant.

Michael Kreidstein, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 28 reviews

Capsular contracture: does the risk increase the longer you have implants?

Thank you for your question!  There is always a risk for capsular contracture with any implant in for a certain amount of time.  Most likely happens the first 3 years after surgery.  Seek a board certified plastic surgeon to have a full discussion with.  Best of luck!Dr Dhaval PatelDouble Board CertifiedPlastic SurgeonChicago Hoffman EstatesOak Brook

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 78 reviews

Capsular contracture

Dear Shoequeen,

In general, breast augmentation performed expertly in the hands of an experienced certified plastic surgeon with a busy breast augmentation practice results in aesthetic breast contours and enhancements with increased volume and projection that are excellent. In the vast majority, the breasts end up soft and natural, depending on the implant selection and where the pocket is placed, either subglandular or under the muscle. The rates of capsular contracture in most practices run between 1% and 2% and most of these capsular contractures occur in the first year.

It is very unusual to have capsular contracture after the first year, although there are certain physiologic circumstances where this can occur. Fortunately, the treatment for capsular contracture is quite successful. My best advice at this point would be to seek consultation with several plastic surgeons in your area that have significant breast augmentation expertise.

I have been performing breast augmentation for 20 years and the addition several years ago of the VECTRA 3D® helps patients select the size and shape of the implant that best suits and matches their aesthetic goals and desires. The 3D imaging takes a photo of your body in three dimensions and you can insert, with the use of the software, different size implants to get a very, very accurate assessment of the kind of aesthetic outcome you might achieve.

For more information, please review the link below as well as the 3D VECTRA page.

I hope this information has been of assistance and best of luck.

R. Stephen Mulholland, MD
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 80 reviews

Does capsular contracture increase with age of implants?

Unfortunately there are no good long term longitudinal studies to answer this question. I have been in practice for 32 years and seen women who developed CC after 6 months and I have seen women who seemed to develop them after 15 years.  I have also seen women who have had their implants for 20 years and they are still very soft and natural. Some studies show a lower incidence when the implants are placed under the muscle.  Keep in mind that there are different degrees of capsular contracture, graded I-IV. It is the grades III and IV that are most likely to require additional treatment, mainly surgery. The Mentor study published in 2006 reported a Baker Grade III/IV rate of 8.1% at 3 years with silicone.   My experience is that it is much lower with the current generation of silicone implants, probably half that or less. I don't think we can compare CC risk with rupture risk -- there just isn't enough data.  Good luck with your decision.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 26 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.