What Causes Capsular Contracture After Breast Implant Augmentation?

There are several possible contributing factors to capsular contracture. While it is not always known why it occurs, there are some potential circumstances that can increase the risk of this complication.

Some of the possible factors that can contribute to capsular contracture after breast implants include:

• Bacteria that create a biofilm around the implants
• Genetic factors – patients that have close relatives who have developed thick scar tissue or have certain autoimmune diseases may be at increased risk
• Trauma to the breast
• Smoking – patients who smoke are at higher risk for hematomas that can contribute to capsular contracture

Capsular contracture is not caused specifically by breast implants – thickened scar tissue can occur with any surgical implant.

What Are the Signs and Symptoms of Capsular Contracture?

There are four possible grades based on the severity of capsular contracture. The signs and symptoms vary depending on the grade and are as follows:

• Grade 1 – Patients may have no symptoms, and the breast will look and feel normal. However, there is excess or hardened scar tissue around the breast implant.
• Grade 2 – The breasts may feel firmer or harder to the touch from the capsular contracture, but the appearance usually is not affected.
• Grade 3 – Patients with grade 3 capsular contracture will have noticeable cosmetic concerns to the breasts. The breasts will be firm or hard and they may look too round, or the nipples may be distorted. There is not usually pain or discomfort.
• Grade 4 – The most severe symptoms are with grade 4, with misshapen and hard breasts like grade 3 but also with pain, discomfort or tenderness in the breasts.

The majority of symptoms of capsular contracture are cosmetic; except for grade 4 discomfort. Capsular contracture does not pose a health risk, in most cases. Grades 3 or 4 could result in damage to the implant, which may require removal for health reasons.