Breast Implants and Capsular Contracture: What You Need To Know

Breast augmentation with implants is one of the most satisfying and safe procedures in plastic surgery. Patients enjoy predictable results and a boost in confidence with their desired cup size. But occasionally, the wheels fall off when a complication called capsular contracture, or “cap-con”, develops.

This is rare, but when it happens, it can create questions, concerns, and disappointment. Let’s take a closer look at what capsular contracture is, why it happens, and how it can be managed.

What Is Capsular Contracture?

After breast implant surgery, it’s normal for a thin, flexible layer of scar tissue (called the capsule) to form around the implant. This capsule usually stays soft and pliable.

Capsular contracture occurs when the capsule surrounding the implant thickens and tightens. This can range from mild firmness to severe hardening.

Symptoms may include:

• A breast that feels firmer than normal
• The implant shifting upward on the chest wall
• Difficulty sleeping on the stomach
• The sensation of “two baseballs” when hugging someone

Interestingly, some patients experience discomfort while others notice only the firmness.

Why Does It Happen?

Over the years, many theories have been proposed. In the early days, patients were instructed to massage their implants daily to “keep the pocket open.” That practice has faded as new research emerged.

The most accepted explanation today is that capsular contracture is linked to a biofilm, a low-grade bacterial colonization that causes chronic inflammation without true infection. While this theory has shaped preventive strategies, capsular contracture can still occur even with meticulous surgical technique.

Once Corrected, Can It Happen Again?

Unfortunately, yes. Patients who have had capsular contracture once may be more prone to developing it again. Even with total capsule removal and surgical precautions, the condition sometimes returns. This can be frustrating for both patient and surgeon.

Preventive Measures Aren’t Perfect

Plastic surgeons take many steps to lower the risk of capsular contracture. These include antibiotic rinses, glove changes during surgery, and other sterile techniques. While these measures help, no method is foolproof. Capsular contracture remains a rare but real risk of breast augmentation.

Treatment Options for Capsular Contracture

When capsular contracture is mild, early interventions may help halt its progression. These can include:

• Oral antihistamines and anti-inflammatory medications
• Massage and wrapping techniques to counteract tightening

If symptoms progress or the firmness becomes uncomfortable, surgical treatment is often necessary.

Surgical Intervention

Breast augmentation revision surgery for capsular contracture typically involves removing both the implant and the capsule. In many cases, the surgeon will also change the implant pocket—for example, moving the implant from below the muscle to above, or vice versa.

Other approaches may include wrapping the new implant in specialized surgical materials to reduce recurrence. Patients who have experienced multiple episodes are often eager to try any available strategy to prevent them from happening again.

Learn more about breast augmentation revision surgery in my related blog post.

When Surgery Isn’t Enough

In rare and difficult cases, capsular contracture may return even after multiple corrective surgeries. At this point, the best option may be to remove the implants permanently. While this is understandably disappointing for both patient and surgeon, it can sometimes be the only way forward.

Breast Augmentation Is Still Safe and Effective

Despite the possibility of capsular contracture, breast augmentation remains one of the most rewarding operations I perform. It is safe, effective, and provides consistently high levels of patient satisfaction. Understanding potential risks helps you move forward as an educated, confident patient.

What’s Next?

Are you interested in breast augmentation or suspect you may have capsular contracture? I invite you to request a consultation using the online form or call us at (614) 569-2649 to schedule an appointment.

Breast Wishes.