Dr. Zuckerman Q&A: What is Capsular Contracture?

Capsular contracture involves the hardening of the fibrous tissue that surrounds all breast implants after implanted in the body. It can occur in the tissue surrounding one or both implants. Capsular contracture varies in its severity, and the most severe type can be painful. Myofibroblast cells, which make up a component of the capsule, the same cells that cause wounds to contract as they heal, will also contract to varying degrees inside your body. 

There are four grades of capsular contracture, known as Baker Grades:

Grade I: Breast is normally soft and looks natural

Grade II: Breast is a little firm but looks normal

Grade III: Breast is firm and looks abnormal

Grade IV: Breast is hard, painful, and looks abnormal

Grades III and IV capsular contracture are considered severe, and may require reoperation or implant removal. Capsular contracture, whether mild, moderate or severe, may occur more than once in the same implant.

The incidence of capsular contracture is quite low: between 4%, as estimated by Ideal Implants in their FDA Patient Labeling, and 8%, as estimated by Mentor in its FDA Patient Labeling, primary breast augmentation patients.