Capsular Contracture FAQs

Breast augmentation surgery with implants provides beautiful and natural results. The vast majority of women enjoy years of satisfaction with the feel and appearance of their breasts. However, every woman does have a risk of an implant problem that may require attention. Capsular contracture is an example of one of the complications that may occur after breast augmentation. Breast revision surgery can correct capsular contracture and restore a natural, beautiful appearance to the breasts.

What Is Capsular Contracture?

When a foreign substance (such as a breast implant) is introduced into the body, the body forms a scar capsule around it. Capsular contracture is when this scar capsule tightens or constricts around the breast implant. This can cause discomfort, hardness, and a visible deformity of the breast.

What Does Capsular Contracture Feel Like?

Capsular contracture is measured by the Baker scale (Grades I, II, III, or IV) in terms of severity. Grade I may not feel any different than a normal breast, but Grades II, III, and IV may feel hard or firm. Grade IV may be quite hard and unnatural. Discomfort or pain is more likely to be present in Grade III or Grade IV capsular contracture.

What Does Capsular Contracture Look Like?

Low-grade capsular contracture (Grade I on the Baker scale) may look no different from a normal breast. Grade II also tends to look generally normal but feels a bit firm. Grade III capsular contracture will begin to look abnormal and have some firmness under the breast tissue. The breast may appear constricted, forced into an unnatural shape, or fixed in one spot on the chest wall (instead of relaxed and malleable like a normal breast). Grade IV capsular contracture (the severest grade) will have the most noticeable distortion.

What Causes Capsular Contracture in Breast Implants?

Capsular contracture occurs for largely unknown reasons. I tell my patients that there is no blood test or physical exam finding that gives them a higher risk. Even more perplexing is that most contractures only occur on one breast even though both breasts have the same implants.

What Helps Prevent Capsular Contracture?

Capsular contracture is difficult to predict or prevent. You may reduce your risk of developing it by selecting an experienced and board-certified plastic surgeon for your breast augmentation procedure. Lower occurrence rates are seen when the implant is placed under the chest muscle instead of just under the breast tissue, using an incision at the breast crease (inframammary approach) instead of around the areola, as well as avoiding smoking or taking medicines that thin the blood. Following your doctor’s recommendations during recovery is the best way to minimize your risk of post-surgical complications.

What Are the Chances of Getting Capsular Contracture?

One scientific literature review indicated that the capsular contracture rate affects 10.6 percent of patients. Since 2011, the risk in my patient population ranges from two to five percent. The risk does vary depending on the implant you choose. The new ‘cohesive’ silicone gel implants lower the risk as do textured silicone implants. Also, your chance of getting capsular contracture will be higher if you have already had capsular contracture in the past. Your likelihood will be lower if you follow the recommendations for prevention and if you are a naturally good healer.

When Is Capsular Contracture Most Likely to Occur?

Capsular contracture can occur at any point after breast augmentation and without any warning. Most cases are likely to take place within the first two years after breast augmentation.

Can You Treat Capsular Contracture Without Surgery?

Patients with mild cases of capsular contracture (Grade I or possibly Grade II) may not need corrective surgery. If there is no visible distortion and you are not bothered by your capsular contracture, you may choose to ignore it. In regard to nonsurgical treatment for capsular contracture, it is thought that some substances such as anti-inflammatory medications or vitamin E supplements may help soften the scar capsule. Patients should discuss their options with their doctor before taking any medications or supplements. Most women with capsular contracture (especially Grade III or Grade IV) will likely need to undergo breast revision surgery.

How Is Capsular Contracture Treated?

Capsular contracture treatment is labeled as a ‘breast revision surgery.’ These are secondary procedures that can correct a number of complications after breast augmentation. Specifically, your surgeon can either release the tight scar tissue (capsulotomy) or remove the scar tissue (capsulectomy), both softening the breast. Usually, at the same time, a new implant is placed. These options will resolve capsular contracture and improve the appearance and feel of your breasts.

Dr. Robert Spies is board certified in plastic and reconstructive surgery and has over 30 years of experience as a plastic surgeon. If you have capsular contracture or any other complication following breast augmentation, Dr. Spies can perform breast revision to restore your breasts. To schedule a consultation, call (480) 359-1019 or complete our online contact form today.