How to Avoid Capsular Contracture in Breast Augmentation

Breast Augmentation

One of the most typical problems following breast implant surgery is capsular contracture. According to statistics, it might happen between 0.5% and 30% of the time. Even a breast artificially reconstructed following a mastectomy should be flexible and supple with a natural drape. Capsular contracture can shift your reconstructed breast, alter the shape, feel firm to the touch, or even feel pain if you have silicone or saline breast implants.

There are techniques to manage capsular contracture, even though it can be alarming or uncomfortable. This blog will explore what capsular contracture is, what causes it, and, most importantly, how to avoid it. Whether you’re considering breast augmentation or have already undergone the procedure, this information will be invaluable in helping you achieve the best possible results.

What is Capsular Contracture?

Any implant, whether medical or aesthetic, typically develops a “capsule” of scar tissue surrounding it as part of the recovery process. Any foreign thing the body senses inside of it triggers an instinctive response that strives to isolate the object by creating a barrier of scar tissue around it. This is typically a beneficial thing in the case of having breast implants. Keeping the capsule helps to maintain the breast implants in line and prevents slippage. However, in certain patients, this scar tissue capsule hardens unnaturally and constricts around the implant. Both aesthetic issues and, in severe circumstances, breast pain can result from this. According to research, approximately one in six women who get breast augmentations experience some form of capsular contracture. However, not all cases are accompanied by overt symptoms. Using a grading system, the degree of capsular contracture is assessed:

  • Grade 1. Asymptomatic grade one capsular contracture (showing or producing no symptoms). The shape, texture, or size of the breasts are unaffected by the development of scar tissue all over the implant. The breasts still feel smooth to the touch and appear natural.
  • Grade 2. Typically, grade two capsular contracture only causes modest cosmetic issues. The breasts often have a regular appearance and a firm feel to the touch.
  • Grade 3. Clear aesthetic indications of grade three capsular contracture are apparent. The breasts will feel tight to the touch and look unnatural, such as being too spherical and hard-looking or having an abnormally shaped nipple. However, there is frequently little to no pain associated with this grade of capsular contraction.
  • Grade 4. Grade four capsular contracture results in rigid, irregular breasts, similar to grade three capsular contracture. Breast soreness is another symptom of grade four capsular contracture; the patient’s breasts are frequently uncomfortable and tender to the touch.

Capsular contracture typically happens throughout the healing phase. Occasionally, many years after a breast augmentation procedure, capsular contractures develop, but this is more of an exception than the rule. If this happens, the patient’s breast implants must be examined for ruptures. The most frequent reason for late-onset capsular constriction is ruptured implants.

What causes capsular contracture?

No matter what type of breast implant is inserted into your breast, capsular contracture can occur. When textured implants are placed sub-glandular or directly beneath the skin between both the pectoral muscle and breast tissue, it appears to be less prevalent surrounding silicone than saline implants. Breast surgeons are moving away with textured implants due to the possibility of getting unusual large cell lymphoma linked to breast implants.

Infections that occur during implant surgery can occasionally lead to capsular contracture. However, additional issues could also arise, such as a hematoma (a bloodstain beneath the skin) or a seroma (a pocket containing blood serum inside the incision site). These also aid in the formation of capsular contracture.

A hereditary propensity for scarring and implant rupture may increase the risk of developing capsular contracture.

Risk Factors for Capsular Contracture

Capsular contracture is a potential complication of breast augmentation surgery that occurs when the body forms a thick, tight scar tissue (capsule) around the implant of the lower armpit area, which can cause discomfort, distortion, and hardening of the breast. While the exact cause of capsular contracture is not fully understood, several risk factors have been identified, including:

  • Implant Type. Capsular contracture is more familiar with textured implants compared to smooth implants. Additionally, silicone implants are more prone to capsular contracture than saline implants.
  • Implant Placement. Placing the implant under the muscle (submuscular placement) is associated with a lower risk of capsular contracture than placing it over the muscle (sub-glandular placement).
  • Trauma or Bleeding. Any kind of trauma or bleeding during or after the surgery can increase the risk of developing capsular contracture.
  • Infection. Bacterial contamination during surgery or after can cause an inflammatory reaction, forming excessive scar tissue and potentially increasing the risk of capsular contracture.
  • Radiation Therapy. Women who undergo radiation therapy after breast augmentation surgery are at a higher risk of developing capsular contractures.
  • Autoimmune Disorders. Certain autoimmune disorders, such as rheumatoid arthritis and lupus, can increase the risk of capsular contracture.
  • Smoking. Smoking has been linked to a higher risk of capsular contracture due to its adverse effects on wound healing and blood flow.

While some risk factors are beyond a patient’s control, discussing them with a qualified plastic surgeon is essential to minimize the risk of developing capsular contracture.

Can Capsular Contracture Be Fixed With Breast Revision Surgery?

Breast augmentation surgery is a procedure that helps women achieve their desired breast shape and size. However, some women experience complications such as capsular contracture after breast surgery. Capsular contracture is the formation of scar tissue around the breast implant, making the breast shape appear distorted, hard, and uncomfortable.

If you are experiencing capsular contracture, you may wonder if breast revision surgery can fix it. The answer is yes, breast revision surgery can treat capsular contracture. A study published in the Aesthetic Surgery Journal found that breast revision surgery with capsulectomy, the removal of scar tissue, significantly improved the appearance and feel of the breast.

So, how does breast revision surgery fix capsular contracture? The technique used depends on the severity of the capsular contracture. The surgeon may remove the scar tissue surrounding the implant in mild to moderate cases. However, in severe cases, the surgeon may need to remove the implant and the scar tissue before replacing the implant. In addition, the surgeon may use antibiotics during the procedure to prevent infection and aid the healing process.

The healing process following breast revision surgery can take several weeks, and postoperative care is essential to prevent complications. In addition to antibiotics, your doctor may recommend using compression garments, massage, and pain medication to alleviate discomfort. It is also important to avoid strenuous activities and follow your doctor’s instructions for postoperative care.

While breast revision surgery can effectively treat capsular contracture, it is worth noting that not all women are good candidates for the procedure. Sometimes, the scar tissue may be too severe, or the implant may be in the wrong position, making revision surgery ineffective. Your doctor will be able to assess your case and determine if breast revision surgery is the right choice for you.

Breast revision surgery can fix capsular contracture, but consulting a qualified and experienced surgeon is essential. In addition, following proper postoperative care and monitoring for signs and symptoms of capsular contracture can help prevent future complications. If you are experiencing capsular contracture, talk to your doctor today to discuss your options for breast revision surgery.

Who is at risk of capsular contracture?

Capsular contracture is a complication that can occur after breast augmentation surgery. It happens when the tissue capsule that forms around the implant becomes tight and contracts, squeezing the implant and causing it to feel hard and distorted. While any woman can develop capsular contracture, some factors can increase the risk.

One of the most significant risk factors is a history of capsular contracture. If a woman has had the condition in the past, she is more likely to develop it again. Certain types of implants, such as textured implants, also pose a higher risk of capsular contracture. Other factors that can contribute to the development of the condition include infections, bleeding, and hematoma.

Studies have shown that factors such as smoking, radiation therapy, and certain autoimmune disorders may also increase the risk of capsular contracture. Therefore, discussing these factors with a surgeon before undergoing breast augmentation surgery is crucial to determine the appropriate course of action.

To minimize the risk of capsular contracture, surgeons may use specific techniques during the operation, such as placing the implant under the muscle or using a Keller Funnel. Post-operative care, such as regular breast massage and avoiding strenuous activities, can also help prevent capsular contracture.

Therefore, women should always consult with a board-certified plastic surgeon to ensure they are an appropriate candidate for breast augmentation and receive personalized recommendations for reducing the risk of capsular contracture.

How to Avoid Capsular Contracture in Breast Augmentation

Breast Augmentation

Plastic surgery has made great strides in lowering the risks of capsular contracture, even though it is impossible to eliminate the risk for every breast augmentation patient. To achieve this, Dr. Smith uses several preventive measures to help guarantee the longevity of your implants. The initial phase is completed long before your operation, and Dr. Smith will check you for any health issues that raise the possibility of problems during the initial consultation. To promote healing, you must stop smoking at least three weeks before your procedure and throughout the healing period.

Here are some tips to avoid capsular contracture:

Choose the Right Implant Type and Size

The best way to lower the risk of capsular contracture is to select the best implant size for your anatomy. The size of the implant that your body’s natural breast tissue can support will be determined by Dr. Smith.

We advise gradually increasing the size of your breasts that are already small or have low volume. In this manner, your body can gradually adjust to a mid-sized implant. Dr. Smith will safely implant a larger implant in the future once your skin extends over time.

Additionally, the kind of implant used would increase complications and risks. Research shows that rough surface gel implants instead of smooth ones lower the risk of capsular contracture. Doctors think this is because the body finds building dense scar tissue around the rough surface a little bit more challenging. However, textured implants are best suited for submuscular insertion and may not be appropriate for all patients. We’ll go through all of your options during your appointment and create a treatment plan that will safely give you the results you want.

Minimize Implant Handling

The risk of bacterial infection can be increased by handling an implant before implantation into the body. Dr. Smith is cautious while handling any implant before inserting it into the breast cavity. Working with such a board-certified plastic surgeon ensures you receive the best care and safety.

Submuscular Implant Placement

Your risk for capsular contracture could be significantly reduced by Dr. Smith placing your implant under the chest muscle. Your overall risk of capsular contracture will only be 4–8% if you choose total submuscular implantation. Even so, the overall risk of capsular contracture is only 10.6% if you opt for over-the-muscle insertion.

Use a Surgical Drain

Using a surgical drain may prevent the growth of bacteria. It is not surprising that blood buildup surrounding breast augmentation surgery is the leading cause of capsular contracture because blood is a primary site for germs. While following surgery, doctors can stop artery and vein bleeding, but they cannot stop capillary leakage. Following breast augmentation, I ask my patients to keep the drains in place for at least 2–5 days to help prevent any blood clots from forming in the chest cavity, which reduces the potential for bacterial growth.

Treatment Options for Capsular Contracture

A possible side effect of breast augmentation surgery called capsular contracture can cause discomfort, breast distortion, and hardening. While prevention is the best strategy, several treatment options are available for patients who develop capsular contracture. Some of the common treatments include:

  • Non-Surgical Management. For mild cases of capsular contracture, non-surgical management can be attempted. This may include massage, compression, and ultrasound therapy to help soften the scar tissue.
  • Capsulotomy. A capsulotomy is a surgical procedure in which the surgeon makes incisions in the capsule to release the scar tissue and allow the implant to move more freely. This can be performed as an outpatient procedure under local or general anesthesia.
  • Capsulectomy. Capsulectomy is a surgical procedure in which the surgeon removes the capsule and implants completely. This is typically reserved for more severe cases of capsular contracture.
  • Implant Replacement. In some cases, simply replacing the affected implant with a new one may be sufficient to treat capsular contracture. This can be done using the same or a different implant type, depending on the patient’s preferences and the surgeon’s recommendation.
  • Strattice Placement. Strattice is a surgical mesh made from pig skin that can reinforce breast tissue and prevent the recurrence of capsular contracture.

The appropriate treatment option for capsular contracture depends on the severity of the condition, the patient’s preferences, and the surgeon’s expertise. It is essential to consult with a qualified plastic surgeon to discuss the best approach for addressing capsular contracture.


Capsular contracture is a potential complication of breast augmentation that can lead to discomfort, aesthetic changes, and the need for additional surgery. However, there are several strategies that can be employed to reduce the risk of developing this condition. Patients can significantly reduce their risk of developing capsular contracture by selecting an experienced surgeon, opting for submuscular implant placement, using smooth-surfaced implants, and following post-operative instructions carefully. Regularly monitoring the implants and seeking prompt medical attention if any symptoms arise can help catch and treat capsular contracture early. By taking these precautions, patients can increase their chances of a successful and complication-free breast augmentation procedure.

Prevent capsular contracture by choosing a board-certified plastic surgeon

Your decision to have breast augmentation performed by a board-certified plastic surgeon is the most crucial measure you can take to prevent capsular contracture. He or she will possess the skill, understanding, and expertise necessary to deliver spectacular, realistic results and aid in preventing capsular contracture.

Choose Smith Plastic Surgery for your breast augmentation

If you are considering a breast augmentation in Las Vegas, whether it’s saline, silicone, or round implants, a Board-certified plastic surgeon in Las Vegas, Nevada, Dr. Smith, is a well-known breast surgeon with over 20 years of experience. Schedule your appointment or consultation now or call us at (702) 838-2455 for questions and information about the procedures for protecting a risk-free breast augmentation procedure and recovery to prevent capsular contracture.