The development of capsular contracture is a nightmare for women who have had breast augmentation surgery. The breasts feel hard, and shift position causing it to look lopsided. In extreme cases, it might also cause a lot of discomfort and pain.



Breast Implants in BreastsFibrous breast capsules are formed around the breast implants when they are inserted during breast augmentation, as the body tries to wall off the presence of the foreign implant. This is the body’s natural immunology response that occurs any time a foreign object is placed into the body, be it a pacemaker, an artificial joint or a breast implant.

When the fibrous capsule tightens and squeezes the implant, capsular contracture occurs.

Anybody can develop capsular contracture, but according to many authors, the occurrence rates are usually about 5%-8% of women with breast augmentation.



Although capsular contracture usually occurs anytime after a breast augmentation, most instances occur in the first few months following the procedure.

The signs of capsular contracture commonly appear gradually and may first be experienced by it being firmer than usual.  a misshapen or high riding breast. As the hardening intensifies, the breast may look misshapen and even painful. The breast can also appear very round, and shift higher up the chest while visible rippling appears. (Read more about rippling of breast implants.)


There are various stages of capsular contracture according to Dr Baker:

Baker Grade One — The breast appears natural in size, shape, and softness. The capsule has formed but it is not tightened around the implant.

Baker Grade Two — The breast appears normal but feels slightly firm. There is a slight to moderate tightening of the capsule around the implant.

Baker Grade Three — The breast not only feels firm but is also beginning to deform. The breast appears round like a ball due to the tightening of the capsule on the implant. In some cases, the implant is displaced from its original position, usually upwards.

Baker Grade Four — The patient exhibits all the signs of Grade Three, with the addition of pain caused by the tightening of the capsule.

Grade Zero — The fibrous capsule is formed loosely around the breast implant, causing the implant to be drooping and sagging within the envelope. Visible rippling of the breast implant may also be noticed.



There is no way a plastic surgeon can predict who will develop a capsular contracture but we have ways that might help to reduce the risk of it happening.

  • Sub-muscular implant placement is correlated with lower rates of capsular contracture as compared to the sub-glandular implant placement. (Read more about breast implant placements here.)
  • Oversize implants might lead to capsular contracture as there might be more trauma to the breast pocket during physical activities. With more trauma, the scar capsule could be injured and it can go on to heal with additional scar, which might be thicker and less elastic than the original scar.
  • Perform breast implant massage at least twice a day for about 10 minutes following a breast surgery. Displacement of the implant inside the breast capsule may help scatter any excess tissue around the implant, reducing the chance of capsular contracture.
  • Avoid smoking until full recovery has been achieved as capsular contracture rates are about twice as high in smokers.
  • Choose a licensed and experienced plastic surgeon to do your breast augmentation. A surgeon who practices in a safe facility with strict infection control policies ensures better results and decreases the risk of capsular contracture.
Breast Implant Massage

Techniques for breast implant massage are usually taught by the plastic surgeon after breast augmentation.



Non-Surgical Methods:

  • Medications — Accolate® has anti-inflammatory properties that have helped to reduce the severity of capsular contracture. It works best for patients in the early stages of capsular contracture.
  • Breast Implant Massage — Again, breast implant massage might help to loosen the capsule in the early stages of capsular contracture.

Surgical Methods:

  • Open Capsulectomy — An open surgery where the entire capsule is surgically removed. During this surgery, the patient can choose whether to replace the implant or use a new one.
  • Open Capsulotomy — An open surgery that involves releasing the scar tissue by scoring the capsule with small incisions. It might also involve partial removal of scar tissue.


To learn more about capsular contracture or to discuss any queries you have, do consult with your plastic surgeon. If you suspect that you may have a case of capsular contracture, talk to your plastic surgeon immediately. Capsular contracture does not heal on its own, in fact, it can get worse over time.


To learn more about capsular contracture, do contact us at:
Dr Marco Faria Correa Plastic Surgery

Tel: +65 64648075


Disclaimer: The information contained in this post is neither intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. Always seek the advice of your plastic surgeon or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Always speak to your healthcare provider about any questions you may have regarding a procedure.