Capsular Contracture

Whilst Breast Augmentation Surgery is considered to be a relatively safe procedure, all surgical procedures carry risks. One of the risks of using implants for Breast Enlargement (augmentation) is the risk of experiencing a ‘capsular contracture’ complication.

What is capsular contracture?

All implants and implanted devices in the body create a normal immune response where a capsule of protective scar tissue (collagen fibres) forms to envelope the implant.  The capsule is formed by your own living tissue. It is normal and happens in everyone regardless of whether the breast implant is smooth or textured, silicone or saline.

In some women, for reasons we don’t understand completely, the capsule has a tendency to shrink, squeezing the implant. This is referred to as capsular contracture. The tighter the capsule becomes the firmer the breast feels. When this happens, the implant may become compressed, deformed, and displaced. It can occur within weeks or years of surgery, in one breast or both.

There are four grades of breast capsular contracture – The grading is as follows:

Grade I the breast is normally soft and looks natural

Grade II the breast is a little firm but looks normal

Grade III the breast is firm and looks abnormal

Grade IV the breast is hard, painful, and looks abnormal.

Can it be prevented?

The first thing to understand is that there is no way to prevent capsular contracture. While there are things that can be done to reduce the risk, there is no foolproof way to guarantee successful prevention.

Because plastic surgeons now have a better understanding of some of the reasons why capsular contracture occurs, there are a number of measures that can be taken to significantly reduce the likelihood that it will happen following breast augmentation surgery.

The following techniques have been employed to fight capsular contracture:

  1. Sub muscular breast implant placement – likely has a role in decreasing capsular contracture
  2. Using textured implants – many recent studies show this is not an effective in preventing capsular contracture
  3. Limiting handling of the implants and skin contact prior to insertion – follows the immunologic basis of capsular contracture indicating that less handing causes lower bacterial contamination and is likely an important concept in preventing capsular contracture
  4. Irrigation with triple-antibiotic solutions – as above although care about solution selection must be used as some solutions void the warranty of the breast implant.


In the vast majority of cases, capsular contracture is treated with surgery. While there are non-surgical treatments that can be tried, such as massaging, but it should be noted that they are very “hit and miss” and none at this point in time that can guarantee results.

In any case, it’s best to discuss with your surgeon what you can do to help treat capsular contracture. It is important that they give you this advice since you may make your condition worse if what you do is done improperly.

The most appropriate treatment for capsular contracture is to have Breast Implant Revision surgery. In this procedure the surgeon will either cut the capsule to release the scar formation or remove the entire thickened capsule surrounding the breast implant.