What is a Capsular Contracture?


When breast implants, or any other foreign object, are placed in the body, the body forms a lining around it. This lining, or capsule, is formed by your own living tissue. Some people refer to it as the “scar capsule” although it is not exactly the same as scar tissue. This is completely normal and happens in everyone regardless of whether the breast implant is smooth or textured, silicone or saline.

Capsular contracture, the most common complication of breast augmentation surgery, can happen at any time, but seems to be more common in the first several months after surgery. Capsular contracture occurs when the capsule shrinks and tightens, squeezing the implant, causing it to feel firmer and sometimes take on a ball-like appearance. It is important to remember that it is not the implant that has hardened. The shrinking of the capsule compresses the implant, causing it to feel firm. However, once the implant is removed, it is just as soft as it was the day it was inserted.

Studies show that up to 26.9% of women who receive breast implant surgery will develop capsular contracture.

What causes Capsular Contracture?

Currently, the causes for capsule contracture are still very unclear. The following are thought to put you at greater risk for developing capsular contracture:

  • Smoking – Smoking decreases the oxygen levels in the blood, which could result in delayed healing, and possibly an inflammatory reaction.
  • Infection – Capsule contracture seems to be more likely following an infection
  • Seroma – If you have had a seroma, you may be at more risk for capsular contracture
  • Subglandular placement – Breast implants placed above the muscle tend to have higher capsular contracture rates, versus breast implants placed in behind the muscle, also known as submuscular placement.
  • Hematoma – Hematomas can cause an inflammatory reaction, which can lead to capsule contracture.

Capsular Contracture is graded with the Baker scale

Grade I – the breast is normally soft and appears natural in size and shape

Grade II – the breast is a little firm, but appears normal

Grade III – the breast is form and appears abnormal

Grade IV – the breast is hard, painful to the touch, and appears abnormal


An in-office consultation with Dr. Mountcastle in one of our Northern Virginia offices is required to determine your best course of treatment. Dr. Mountcastle usually treats capsular contractures by performing a capsulectomy in the hospital. This is the preferred method among plastic surgeons for capsular contractures. This is a process in which the entirety of the thickened capsule surrounding the implant is removed. This procedure is performed to prevent future recurrent capsular contractures from forming. The implant may be replaced during this procedure for best results.