What Is Capsular Contracture? Hardening Around a Breast Implant

After a breast implant is placed, the body forms a thin layer of tissue around it as a natural response to a foreign object. This is called a “capsule” and in most people it causes no problems. In some people, however, the capsule can thicken and tighten over time; this is known as capsular contracture. In this article we explain in general terms what capsular contracture is and how it is assessed.

Why does a capsule form?

The body creates a layer of connective tissue around the implant. This is a normal part of healing and also helps keep the implant in place. A normal capsule is thin and soft; the breast feels natural to the touch and keeps its shape.

How is capsular contracture noticed?

When the capsule thickens and contracts, it can squeeze the implant. The following may then be noticed:

• a feeling of firmness in the breast,
• the breast looking rounder or sitting higher,
• an increasing difference in shape between the breasts,
• in advanced cases, tightness, discomfort or pain.

Capsular contracture is graded according to its findings, from mild firmness to marked distortion and pain. It can affect one or both sides and may appear shortly after surgery or years later.

Which factors may play a role?

The cause cannot always be traced to a single factor. Bacterial contamination, blood collecting at the surgical site, the placement plane of the implant and previous radiotherapy to the area are thought to play a role. Although certain technical measures during surgery aim to reduce the risk, it cannot be guaranteed that capsular contracture will never develop.

How is it assessed?

If firmness or a change in shape is noticed, the first step is an examination by a physician. If needed, the implant and surrounding tissue are assessed with imaging such as ultrasound or MRI. Mild cases without symptoms may simply be monitored, while cases causing clear symptoms may lead to surgical options such as partial or complete removal of the capsule and implant exchange. The appropriate approach is decided individually.

Frequently Asked Questions

Is capsular contracture dangerous?

Capsular contracture is mostly a problem of appearance and comfort. However, any new change in the breast may have other causes and should always be assessed by a physician.

Does massage prevent capsular contracture?

Some surgeons recommend specific massage after surgery; this depends on the implant type and technique. Only massage in the way your surgeon has shown you.

Can capsular contracture come back after treatment?

Recurrence is possible and varies from person to person. This should be discussed openly with your surgeon when planning treatment.

For more information, visit our Breast augmentation page and our article on implant lifespan, and reach us via our contact page.

This article is for informational purposes only; a medical examination by a physician is required for diagnosis and treatment.