What is capsular contracture?
Capsular contracture is the tightening and hardening of scar tissue that naturally forms around a breast implant, causing the implant to feel firm or distorted.
When a breast implant is placed during augmentation, the body responds by forming a thin capsule of scar tissue around it. In some cases, this capsule tightens abnormally over time, a condition called capsular contracture. The implant becomes increasingly firm, and the breast may feel hard, appear misshapen, or sit higher on the chest than intended.
Surgeons grade capsular contracture using the Baker scale, which ranges from Grade I (soft, normal) to Grade IV (hard, painful, and visibly distorted). Grade III and IV contractures typically require revision surgery to restore comfort and appearance.
Contracture risk involves several factors. Implant textured surfaces carry higher rates than smooth surfaces, though smooth implants can still develop this complication. The body's individual healing response plays a role, as does infection following surgery or implant rupture over time. Some evidence suggests that mammary implant-associated anaplastic large cell lymphoma (BIA-ALCL) cases correlate with certain implant designs, leading some surgeons to adjust material choices and follow-up protocols.
Working with an experienced breast augmentation surgeon helps minimize risk through surgical technique, implant selection, and proper post-operative care. Understanding contracture is essential for anyone considering or living with breast implants.