Capsular Contracture

Capsular contracture is a condition in which the fibrous capsule that naturally forms around a breast implant becomes abnormally thickened and tight, leading to firmness, discomfort, and visible distortion of the breast. It can develop months to years after implantation and is commonly graded by severity (Baker I–IV), with symptoms ranging from subtle firmness to painful hardening or implant displacement.

The exact cause is multifactorial and may include bacterial biofilm, hematoma or seroma, implant surface and placement, and individual healing responses. Management options vary by severity and patient goals and include observation and medical therapies for mild cases, and surgical approaches such as capsulotomy, capsulectomy, implant exchange or removal for more advanced contracture, with surgical technique and pocket selection used to reduce recurrence risk.