Breast implant surgery done by even the most skilled plastic surgeons can result in a phenomenon called capsular contracture. The body’s natural response to foreign material, such as a breast implant, is to create scar tissue. In the breast pocket, this scar tissue is called a capsule and, in some cases, can become very hard and dense. Capsular contracture can lead to aesthetic issues and overall pain and discomfort. Depending on the stage in which capsular contracture has developed, treatment options are open for discussion with your board-certified plastic surgeon.

What Causes Capsular Contracture?

While the exact cause of capsular contracture is not fully understood, there are several factors that may contribute to its development. It is important to understand that the cause of capsular contracture varies from patient to patient. Here are some factors that may contribute to the development of capsular contracture:

Implant Type: Certain types of breast implants such as those with a textured surface may have a higher risk of developing capsular contracture compared to those with a smooth surface.

Postoperative Complications: Complications following surgery such as infection or bleeding may increase the risk of capsular contracture.

Implant Rupture: The result of a breast implant rupture can trigger an inflammatory response within the breast pocket and increase the likelihood of developing capsular contracture.

Genetics: Individuals with a family history of autoimmune disease or other scarring predispositions may play a role in the development of capsular contracture.

Grading Scale for capsular contracture

Assessment for capsular contracture is evaluated based on the Baker scale. It is a qualitative scale which utilizes breast firmness, how the implant feels, and implant visibility. The Baker scale uses the following means of grading:

Grade I: breast soft, implant nonpalpable, implant nonvisible.

Grade II: breast minimally firm, implant palpable, implant nonvisible.

Grade III: breast moderately firm, implant easily palpable, implant distortion visible.

Grade IV: breast severely firm, implant hard, tender, cold, implant visibly distorted.


If capsular contracture does occur, there are some treatment options available depending on the severity of the condition. Early-stage capsular contracture is often treated with massage, medication, or other therapies. There are certain anti-inflammatory medications indicated to improve the condition. More severe cases of capsular contracture may require breast revision surgery with or without an implant exchange. To remove or release the capsule an additional procedure may be tacked onto the breast revision. During a capsulotomy the capsule would be partially removed or released and during a capsulectomy the capsule would be fully removed from the breast pocket. Overall, the treatment plan depends on the severity of the condition.


Capsular contracture is a potential complication of breast implant placement. This is a potential complication to be aware of when undergoing breast surgery but there are many options available to correct this. With the help of your surgical team and your own awareness, early detection of this phenomenon is essential for treatment. If you are looking to book a consultation with board-certified plastic surgeon Dr. Kim, please contact our clinic at 312-694-0879 or through the request form in the header.