Capsular contracture is one of the most discussed—and misunderstood—complications in breast augmentation and breast implant revision surgery. While it is relatively uncommon, it can significantly affect breast appearance, feel, and comfort.
The good news: advances in surgical techniques, implant technology, and postoperative management have dramatically reduced the risk. For patients considering breast augmentation or implant revision, understanding capsular contracture is essential for long-term satisfaction and peace of mind.
This guide explains what capsular contracture is, why it happens, how to prevent it, and the modern treatment options available.
After breast augmentation, the body naturally forms a protective layer of scar tissue—called a capsule—around the implant. This capsule is normal and expected.
Capsular contracture occurs when this capsule becomes abnormally tight, thick, or hard, causing:
The severity is usually described using a grading scale (I–IV), with higher grades indicating more noticeable tightness and distortion.
While the exact cause is not always clear, several well-studied factors are known to increase the risk:
This can be due to bacterial contamination, microscopic biofilm, or even chronic irritation around the implant.
Blood or fluid around the implant can trigger inflammation that makes scar tissue more aggressive.
Silicone leakage can irritate surrounding tissue, increasing contracture risk.
Implants placed above the muscle (subglandular) historically have a higher risk than those placed partially under the muscle (dual-plane).
Patients with a history of contracture are more likely to experience it again without additional precautions.
Radiation can thicken tissues and increase scarring tendencies.
Recognizing capsular contracture early allows for faster intervention.
Common symptoms include:
Patients should contact their surgeon immediately if changes appear months or years after surgery.
Thanks to modern advances, many surgeons now report lower contracture rates than ever before. Prevention focuses on reducing inflammation, minimizing bacterial exposure, and optimizing implant placement.
Using devices like a sterile funnel or specially designed insertion tools allows surgeons to place the implant without touching the skin, reducing potential contamination.
Positioning the implant partially under the chest muscle:
This approach is now standard for many patients.
Modern surgeons use specialized sterile solutions to irrigate the implant pocket, minimizing inflammation and decreasing bacterial presence.
Today’s silicone implants are:
These improvements help maintain stability and reduce irritation over time.
Soft-tissue reinforcement can stabilize implants and limit pocket movement—an important step for patients with weaker tissues or revision surgery.
Surgeons now emphasize:
Much of prevention depends on how closely patients follow their postoperative instructions, which significantly influences long-term results.
Even with prevention, contracture can still occur. Fortunately, treatment methods have evolved and become more effective.
Mild contracture may be addressed with:
While these methods aren’t always curative, they can slow progression and reduce discomfort.
For moderate to severe cases, surgery is the most predictable solution.
What it involves:
A total capsulectomy may be preferred when the capsule is thick, calcified, or causing significant distortion.
Switching from above-muscle to dual-plane placement significantly reduces recurrence rates. This is a common strategy during revision surgery.
These materials act as an internal scaffold, helping prevent future tightening and stabilizing the implant position.
This approach is especially helpful for:
In rare cases, patients may choose to remove implants entirely. A breast lift can be performed at the same time to maintain a youthful shape.
Patients may have an increased risk of capsular contracture if they:
A consultation with a board-certified plastic surgeon allows for customized planning to minimize those risks.
With modern surgical approaches and improved implant technology, the long-term outlook is far better than it was even a decade ago.
Patients can reduce recurrence risk by:
When performed with today’s advanced techniques, many patients enjoy long-lasting, soft, natural results with a low chance of recurrence.
Capsular contracture can be concerning, but with modern understanding and improved surgical strategies, it is far easier to prevent and treat than ever before. Whether you’re considering breast augmentation or seeking revision for existing implants, the key is partnering with a skilled, board-certified plastic surgeon who prioritizes safety, precision, and long-term outcomes.
Dr. Albright uses the most advanced techniques available to minimize risk and help patients achieve soft, natural, and durable breast enhancement results.
