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Capsular Contracture

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Capsular contracture is a common complication of breast augmentation surgery, where the tissue around breast implants becomes tight and may cause discomfort or distortion. Dr. Lalezar offers numerous treatment options for capsular contracture, ranging from massage to the removal and/or replacement of breast implants.

What Is Capsular Contracture?

Capsular contracture occurs when the body’s natural response to a foreign object, like a breast implant, results in the formation of a tight, thick scar tissue capsule around the implant. This capsule can squeeze and distort the implant, leading to discomfort, pain, and an unnatural appearance of the breast. Capsular contracture is graded on a scale with varying degrees of severity and may require treatment to alleviate symptoms and restore a natural appearance.

The Grades of Capsular Contracture:

Grade I: In this early stage, the breast appears natural, feels soft, and there is no visible distortion. The scar tissue capsule around the implant is minimal, and there is no discomfort.
Grade II: The breast may start to feel slightly firm, and there might be mild distortion in shape. The capsule is thicker than in Grade I, and the patient may experience mild discomfort.
Grade III: The breast becomes noticeably firm, and there is noticeable distortion in shape. Discomfort is more pronounced, and the scar tissue capsule is thickened significantly.
Grade IV: The breast is firm, painful, and severely distorted. The capsule is very thick, and the implant may be visibly misshapen. Grade IV contracture necessitates immediate treatment.

Signs & Symptoms of Capsular Contracture:

  • Increased firmness or hardness of the breast
  • Change in breast shape or appearance
  • Pain or discomfort in the breast
  • Visible implant distortion or displacement
  • Tightness or pressure sensation in the breast

Possible Causes of Capsular Contracture:

  • Immune system response to the implant
  • Bacterial biofilm formation around the implant, triggering an inflammatory response
  • Silicone leakage from the implant, leading to capsule formation
  • Subglandular placement may increase the risk compared to submuscular placement
  • Postoperative infections can lead to more severe contractures
  • Some individuals may have a genetic susceptibility to contracture formation

Treatment Options for Capsular Contracture


Massage is often one of the initial strategies for managing mild cases of capsular contracture. This non-invasive technique involves gentle, manual manipulation of the breast tissue to help break up the scar tissue capsule surrounding the implant. Regular, directed massage can help maintain or improve breast implant mobility and reduce discomfort. While it may be effective for Grade I and some Grade II contractures, more advanced cases may require surgery.

Scar Tissue Removal

Scar tissue removal is a common approach to treating moderate to severe capsular contracture. In a capsulotomy, the surgeon makes incisions in the existing scar tissue to release the tension and improve breast implant mobility. Capsulectomy involves the complete removal of the scar tissue capsule. Both procedures restore a more natural breast appearance, reduce discomfort, and prevent contracture recurrence. The choice depends on the severity of the contracture.

Breast Implant Replacement

In cases where capsular contracture is recurrent or severe, replacing the breast implants may be necessary. During this procedure, the surgeon removes the existing implants and the scar tissue capsule. New implants may be inserted, often accompanied by adjustments to implant size, shape, or placement to achieve a more desirable aesthetic outcome. This option is suitable for Grade III and Grade IV contractures and can provide long-term relief.

Breast Implant Removal

In some cases, patients may opt for complete breast implant removal if they no longer wish to have implants. This is a viable choice for individuals experiencing severe discomfort, pain, or dissatisfaction with their breast augmentation results. After implant removal, the scar tissue capsule may also be removed. After completely removing the breast implant, the patient may opt for a breast lift to tighten the remaining skin and improve the aesthetic results.

Schedule Your Consultation

Dr. Frank Lalezar is a board-certified plastic surgeon renowned for being a true master of the art of aesthetic surgery. If you are experiencing capsular contracture or are considering breast augmentation, please schedule a consultation with Dr. Lalezar. He provides comprehensive consultations and offers ongoing support and care to all his patients, helping you achieve your aesthetic goals while ensuring optimal safety and comfort.

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635 Madison Ave. W,
17th floor, Suite 1A,
New York, NY 10022
CONTACT US 646.887.5533