Capsular Contracture

Capsular contracture of the breast is the formation of a thickened or scarred capsule around a breast implant. The breast capsule is a tissue layer created by your body surrounding the implant.


The cause of capsular contracture is not known, however capsular contracture has been associated with bacterial contamination of the implant, implant rupture, and hematoma.

Diagnosis and Symptoms

The degree of capsular contracture is graded on the four grade Baker scale and have the following symptoms.

  • Grade I — the breast is soft and appears natural in size and shape
  • Grade II — minimal contracture; the breast is a little firm, the patient has no complaint
  • Grade III — moderate contracture; the breast is firm
  • Grade IV — severe contracture; the breast is hard, painful to the touch, and appears abnormal

Surgical Treatment

Current surgical techniques help reduce the incidence of capsular contracture. The placement of the implant under the muscle, use of antibiotic irrigation, minimal manipulation of the implant prior to placement, and incision location may help reduce the rate of capsular contracture.

The treatment of capsular contracture usually requires removal of the current breast implant along with the surrounding breast capsule. New implants may then be placed and drains are usually required. Alternative treatments have been developed involving the use of acellular dermis. Acellular dermis may be placed as a spacer graft in the breast capsule. The graft works to prevent a circumferential contracture. Use of acellular dermis is generally reserved for patients with severe cases or recurrent cases of capsular contracture.

If you have capsular contracture schedule an appointment with a board certified plastic surgeon like Dr. David Bray, Jr. to review your options. To make an appointment call 310-326-9400.