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Capsular Contracture

Capsular contracture is the most common complication associated with breast augmentation. Any time a foreign body, such as a breast implant, is placed in the body the natural physical response is to form a capsule of scar-like tissue around the unrecognized object. Capsular contracture, most common during the first months following breast augmentation, occurs when this capsule squeezes on the implant, causing the breast to harden.

While the development of the tissue capsule around the breast implants is expected and normal, capsular contracture is neither. The pocket that is made for the breast implant should remain open, allowing the implant to sit in the body with a natural look and feel. During capsular contracture the fibrous tissue surrounding the implant begins to squeeze in and apply pressure, causing the implant to feel hard and the breast to resemble a tennis ball in shape and density.

Risk Factors and Causes

The exact cause of capsular contracture, beyond the presence of breast implants, is unknown. There are some factors, however, that are thought to increase the risk of capsular contracture.

  • germ or bacterial contamination of the implant shell
  • infection
  • seroma
  • hematoma
  • other local complications

Capsular contracture may also be more common when the implants are placed in the subglandular position rather than under the muscle. Smoking can cause delayed healing after breast augmentation surgery, which might also increase the risk of capsular contracture.


When a breast augmentation patient develops capsular contracture there are medical techniques that can be employed to remedy the complication.

Closed capsulotomy is when the surgeon will squeeze the implant hoping to "pop"? open the scar capsule. This procedure is not recommended by implant manufacturers because it can cause the implant to rupture, bringing additional complications. For this reason, closed capsulotomy is not the preferred way to treat capsular contracture.

Open capsulotomy is a surgical corrective procedure, whereby the surgeon makes a periareolar or inframammary incision to enter into the pocket and make cuts into the scar tissue. These cuts, or scores, are made to release the tension around the implant caused by capsular contracture.

The most successful treatment for capsular contracture is open capsulectomy. During this surgical procedure, the surgeon will actually cut the scar capsule out of the body. The body will then form a new capsule around the implant.

The most extreme surgical option to treat capsular contracture is to remove the implants altogether.

Contact A Board Certified Plastic Surgeon Near You

There are a number of additional ways that capsular contracture can be treated. There are also a number of ways to reduce the risk of developing this breast augmentation complication. If you would like to learn more about capsular contracture, please contact us to speak with a qualified and experienced plastic surgeon in your area.