What You Need to Know About Capsular Contracture

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What is capsular contracture?

Capsular contracture is a medical term to describe the scar around the breast implant. With any foreign object, whether it be a breast implant, port for chemotherapy, or knee replacement, our bodies will naturally form a scar around it. This scar tissue is sometimes called “the pocket.” 

For reasons not fully understood, the pocket or scar tissue will sometimes contract or get smaller around the foreign body. When this happens it's referred to as capsular contracture. 

Because the breast implant is the only squishy thing we put in our bodies, capsular contracture can misshape the implant, making the breast asymmetrical and tender.

What capsular contracture isn’t 

Here's the deal, you're not going to wake up from surgery with the breasts of your dreams. But don't panic.

In the initial weeks after your breast augmentation, it is completely normal for your breasts to be asymmetrical, high, and tight. This is not capsular contracture because it takes at least 6 weeks for that pocket to form. The pocket can’t squeeze if it hasn’t been made.

Don't believe us? Ask the Bustmob Community, a private and supportive group for women who are planning to or have had plastic surgery. The community is a safe space for you to post pictures, ask questions, and connect with other women on their very own plastic surgery journey. A little support goes a long way in recovery.

The asymmetry and “high and tight” appearance of your breasts, sometimes called “frankenboob,” are a normal part of recovery after a breast augmentation. As your body heals, swelling reduces, and the muscles relax, your breasts will begin to “drop and fluff.” 

Learn more about what to expect for breast augmentation recovery with the free Bustmob Academy app.

Breast augmentation after photo of "frankenboob" at 2 and 6 weeks
"Frankenboob" progress after photo at 2 and 8 weeks post-op. Check out the Bustmob GoalFinder for +5000 real after photos.

What does it feel like?

If you have capsular contracture, you’ll typically feel tender and tight in the affected breast. You may see some asymmetry and feel like one breast is firmer than the other. 

Capsular contracture isn’t cancer, medically harmful, or a medical emergency–so even if you feel you may have capsular contracture, you don’t have to be seen right away. 

However, you’ll want to know if it is in fact capsular contracture that’s causing the discomfort and likely want it treated, so be sure to schedule an appointment for an exam with your surgeon.  

When can it happen?

Capsular contracture can’t happen until the pocket has formed, which is typically any time after the 6-12 week mark. So if you find yourself asymmetrical before that time, relax. You can have peace of mind that what you’re experiencing is normal. 

The downside to capsular contracture is that it can happen anytime after that pocket is formed, meaning that there is a possibility of having capsular contracture for as long as you have your implants.

What kind of risk are we talking about here?

At Amelia Aesthetics, the risk of developing capsular contracture early on is between 1% and 5%. What is harder to nail down is what the risk looks like over time. 

In other words, if a woman is planning to keep her implants for 20-30 years, and we certainly hope she does, it’s not exactly known what her chances of getting capsular contracture eventually are.

A lot can happen in 30 years–patients move, plastic surgeons retire–so it can be hard to know if or when a patient develops capsular contracture later down the road. 

Can capsular contracture be treated?

Yes, capsular contracture is treated with another surgery under full anesthesia. Your surgeon will remove the old implant and some or all of the scar tissue and replace the implant with a new one. Every once in a while, a patient may need another surgery as a “plan C”, but it isn’t common so don’t stress. 

Is there anything I can do it prevent it?

There are so many factors that play into capsular contracture and the exact cause isn’t known so there isn’t a one-size-fits-all solution. But there are some things you can do to significantly lower your chances like:

  1. Placing the implant under the pectoral muscle (submuscular placement)
  2. Doing a crease incision
  3. Using in-surgery sanitation protocols and procedures

Under the muscle or submuscular implant placement is 6-10 times less likely to have capsular contracture than over the muscle or subglandular placement. Crease incisions have 2-2.5 times lower risks than incisions around the nipples or under the arms.

Also, in-surgery procedures like using tegaderms and keller funnels along with betadine and antibiotics in the wash around the implant will significantly drive down those chances. 

Learn more about breast implant placement and the different incisions in the Bustmob Academy app

Found this helpful, but want more? 

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Gretta Nance
Lead Educator, Amelia Aesthetics
Dr. Michelle Roughton
Board-Certified Plastic Surgeon
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