Capsular Contracture in Miami, FL
Causes, Symptoms, and Advanced Treatment Options
Breast implants are designed to feel soft, natural, and comfortable. In most patients, they do. However, in some cases, the body’s normal healing response can become excessive, leading to a condition known as capsular contracture. This healing process involves the body forming a capsule of scar tissue around the implant as a response to the foreign body.
Capsular contracture is one of the most common reasons patients seek revision breast surgery. Research indicates that about one in six breast augmentation patients may experience some degree of capsular contracture. It can affect comfort, appearance, and confidence, sometimes months or even years after the original procedure.
What Is Capsular Contracture?
Whenever a breast implant is placed in the body, your immune system forms a thin layer of scar tissue around it, called a tissue capsule. This tissue capsule is composed of fibrous scar tissue and is a normal and expected part of the healing process.
Capsular contracture develops when this fibrous scar tissue tightens and thickens abnormally, compressing the implant. As the capsule contracts, the breast may feel firm or painful, and its shape can become distorted. These changes are known as capsular contracture symptoms, with the most common symptoms including increased firmness, tightness, pain, and changes in breast shape or position.
Capsular contracture can occur after cosmetic breast augmentation surgery or reconstructive breast surgery, even when the original surgery was performed correctly.
The risk of capsular contracture is influenced by multiple factors, including implant type, surface texture, surgical technique, and biological responses. Early detection of capsular contracture symptoms is important for effective management and treatment.
What Causes Capsular Contracture?
The exact causes of capsular contracture are not fully understood, but factors such as bacterial contamination, hematoma, and individual healing responses may contribute.
There is rarely a single cause for capsular contracture. Capsular contracture is thought to result from a combination of biological and mechanical factors, which may include:
- Low-grade bacterial contamination around the implant, particularly from staph bacteria, can form a biofilm on the implant surface, increasing the risk of chronic inflammation and capsular contracture.
- Genetic predisposition, especially in individuals with a family history of autoimmune disease or thick scar tissue formation, can increase the risk of developing capsular contracture.
- Hematoma or seroma accumulation around the implant can increase localized inflammation and scar tissue formation, raising the risk of contracture.
- Prior radiation therapy can increase the risk of developing capsular contracture after breast reconstruction surgery.
- Chronic inflammation or bleeding, including hematomas (blood collections) that occur during surgery, can increase the risk for capsular contracture.
- Implant rupture or silicone gel leakage.
- Implant surface characteristics, particularly surface texture: textured implants are associated with a lower risk of capsular contracture compared to smooth implants.
- Implant placement above or below the muscle: submuscular placement is linked to a lower incidence of capsular contracture, while subglandular placement is linked to a higher incidence.
- Individual healing tendencies and immune response.
Importantly, capsular contracture is not caused by anything a patient did wrong. It reflects how the body responds to a foreign object over time.
How Do I Know If I Have Capsular Contracture?
Capsular contracture often develops gradually. Common signs may include:
- Increasing firmness or tightness of one or both breasts
- A breast that feels hard or unnatural
- Visible shape distortion or asymmetry
- The breast implant sitting higher on the chest
- Pain or discomfort, especially with movement or pressure
Discomfort may be more noticeable during activities that engage the chest muscles, such as lifting or exercising.
Early detection of capsular contracture symptoms is important for effective management and treatment. Regular follow-up visits with your surgeon allow for early detection and intervention of capsular contracture.
Capsular contracture is commonly classified into severity grades, from mild firmness to severe pain and visible deformity. A physical examination by your plastic surgeon is the most reliable way to determine whether capsular contracture is present and how advanced it is.
Classification and Staging of Capsular Contracture
Understanding the severity of capsular contracture is important for anyone considering breast augmentation surgery.
Capsular contracture is classified into stages using the Baker grading system, a subjective system based on the physician’s clinical findings. This system helps both patients and surgeons communicate clearly about the condition and select the most appropriate treatment option.
The Baker grading system divides capsular contracture into four distinct grades:
- Grade I: The breast feels soft and looks natural, with no visible or palpable signs of contracture. Most breast augmentation patients fall into this category after surgery.
- Grade II: The breast is slightly firm to the touch but still appears normal. There may be mild discomfort, but the breast shape is not noticeably altered.
- Grade III: The breast is firm and may look misshapen or unnatural. The implant may be more visible, and the breast shape may appear distorted, though pain is usually mild or moderate.
- Grade IV: The breast is hard, painful, and clearly misshapen. Severe capsular contracture at this stage can cause significant physical discomfort and emotional distress, often requiring surgical intervention.
By staging capsular contracture using the Baker grading system, plastic surgeons can better tailor treatment plans to each patient’s needs. Early or mild cases may be managed with observation or non-surgical therapies, while more advanced grades often require revision surgery to restore a natural breast shape and comfort. Understanding these stages empowers you to recognize changes in your breast and seek timely care if symptoms develop.
How Is Capsular Contracture Treated?
Capsular contracture treatment depends on severity, symptoms, and surgical history.
Cases of capsular contracture vary in severity and may require different treatment approaches. Options may include:
- Non-surgical therapies such as ultrasound therapy, massage, and medications to reduce inflammation and manage early-stage contractures
- Surgical release or removal of the surrounding tissue capsule
- Implant exchange or removal
- Changing the implant pocket or plane
- Use of newer implant technologies
- Adjunctive techniques designed to reduce inflammation and recurrence
The earlier grades of capsular contracture can sometimes be managed without surgery, while Grades III and IV usually require surgical correction for lasting relief.
What Problems Can Capsular Contracture Cause?
Capsular contracture affects more than just appearance. Patients may experience:
- Chronic discomfort or pain
- Breast distortion or asymmetry
- Limited implant mobility
- Interference with exercise or daily activities
- Emotional distress or loss of confidence
Addressing capsular contracture is about restoring comfort, function, and trust in your surgical outcome.
Are All Breast Implants the Same When It Comes to Capsular Contracture?
No. Implant type, surface, placement, and surgical technique all influence the risk of capsular contracture. For example, capsular contracture from textured implants will be handled differently from capsular contracture from silicone implants. Similarly, fibrous scar tissue around breast implants may be treated differently from tissue surrounding a facial implant.
While no implant eliminates capsular contracture entirely, modern implant designs and evolving surgical strategies aim to reduce inflammation and improve long-term outcomes. Choosing the right approach requires careful evaluation and experience with complex breast surgery.
Can Capsular Contracture Recurrence Happen?
Yes, capsular contracture recurrence is possible. Patients who have developed capsular contracture once may be at higher risk of developing capsular contracture again, even after revision surgery. Capsular contracture is a known risk, and it is important to explore strategies to prevent capsular contracture, including both medical and surgical approaches.
Following postoperative care instructions and choosing an experienced board-certified plastic surgeon can significantly reduce the risk of complications, including capsular contracture. Regular follow-up visits with your surgeon are also important for early detection and intervention if capsular contracture develops.
This reality is why prevention strategies and new treatment approaches remain a major focus of clinical research.
Advancing Capsular Contracture Treatment Through Clinical Research
Careaga Plastic Surgery is actively involved in clinical research aimed at improving outcomes for patients with capsular contracture.
Below is information about an ongoing clinical study evaluating an advanced treatment approach for capsular contracture.
Now Enrolling: Capsular Contracture Clinical Study
Led by Dr. Daniel Careaga in Miami
Have you noticed one of your breast implants becoming hard, tight, or painful over time?
You may be experiencing capsular contracture, a condition in which scar tissue forms around the implant, altering its shape and sometimes causing discomfort.
Our research team is currently conducting a clinical study evaluating a surgical technique that involves wrapping the implant in an absorbable mesh as part of treatment for capsular contracture.
Qualified participants may:
- Receive the mesh at no cost
- Be compensated for time and participation
- Benefit from treatment led by a double board-certified plastic surgeon with extensive experience in complex breast surgery
Meet Dr. Daniel Careaga
Dr. Daniel Careaga is a double board-certified plastic surgeon with over 15 years of private practice experience in Coral Gables, Florida.
As Medical Director of Careaga Plastic Surgery and Absolute Medical Center, he combines advanced surgical techniques with clinical research to bring innovative, evidence-based treatments to his patients. His practice is known for precision, safety, and natural results.
Are You Eligible?
You may qualify if you:
- Have breast implants and are experiencing capsular contracture
- Are interested in learning more about treatment using absorbable mesh
- Are willing to participate in a research study at our Coral Gables location
Participation begins by completing the contact form below. Our research team will reach out to discuss eligibility and next steps.
Don’t let capsular contracture limit your comfort or confidence.