capsular contracture - can ultrasound picture show in black and white that capsular contracture occurred or that it didn't?

Thank you for your question.  Typically the best and most reliable way to make the diagnosis of capsular contracture is by physical exam and history.  The feel of the implant is quite important and how this has changed over the past months or years is key. 

The best way to determine if you have a capsular contracture is by physical examination by a plastic surgeon with experience in breast augmentation.

And ultrasound might demonstrate a round shape to the prosthesis consistent with capsular contracture but your plastic surgeon can make a diagnosis in one minute by physical examination.

and not by some radiographic study.  Either your breast is soft or not.  Capsules can be thin and still contract so an ultrasound will not be helpful.  If you refer to your pre-op photos, you should be able to discern if one side was smaller or the chest wall more prominent to help explain your post-op asymmetry.  Finally, if you appreciate one breast getting smaller, you could have a contracture or if a saline implant, a bad valve that is slowly leaking.

capsular contraction is a clinical diagnosis. An ultrasound may show a very thick capsule but milder forms may not be apparent with imaging.