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What Is Capsular Contracture?

Breast augmentation is a very satisfying procedure for the vast majority of women as it provides them with fuller, firmer and more attractive, alluring breasts. With this often comes greater confidence, self-esteem, and feelings of increased sexual attractiveness with improvements in their sex life. Nevertheless, like any surgical procedure, there are potential risks for problems with breast enlargement surgery. One of these is capsular contracture.

What is capsular contracture?

Capsular contracture is the formation of firm scar tissue around the breast implant, which results in the breast feeling less than naturally soft.

Whenever there is a foreign material in the body, our immune system’s response is to form scar tissue around it, and breast implants are no different. Typically, this “capsule” that forms is thin, soft, and pliable and does not impact the feel or shape of the implant. For reasons that are not completely understood, this capsule sometimes shrinks and tightens around the implant, resulting in what is known as capsular contracture. In this situation, the affected breast will feel firm, is often distorted in appearance, and there may be some associated pain.

Capsular contracture most commonly occurs within the first two years but can occur at any point in time thereafter as well. Fortunately, its incidence rate has declined over the years but may be somewhere around 5% to 15% for its most clinically significant form.

Baker Grading System

Capsular contracture is classified by the degree of severity using the Baker Grading System.

Grade I

The breast looks and feels soft (the capsule has formed but is not contracted).

Grade II

The breast looks normal but feels slightly firm (mild to moderate contracture).

Grade III

The breast feels firm and begins to appear distorted (severe contracture).

Grade IV

The breast feels firm, is distorted, and causes pain (severe contracture).

Treatment for Capsular Contracture

For patients who start developing increased firmness of their breasts, I will start them on a high dose of Vitamin E and breast compression exercises which are done several times a day. The intent of this is to stretch out the capsule, resulting in the breasts feeling soft again. This regimen can be quite successful in those patients who don’t have the most advanced state of hardness.

If there is not an adequate response to this approach or the breasts have an advanced stage of capsular contracture, then breast revision surgery is recommended. This would entail the removal of the thickened and contracted capsule from around the implant (a procedure known as a capsulectomy) and placement of a new breast implant. The result should be restoration of a normal appearing and feeling breast.

For more information about breast augmentation surgery or breast revision surgery, please call Arizona Center for Breast Surgery at (480) 451-3000 or fill out our online contact form today. Dr. Steven Turkeltaub is board certified by The American Board of Plastic Surgery (ABPS) and has extensive experience providing his patients with safe and effective breast enhancement procedures.