Capsular Contracture: Causes, Symptoms, and Advanced Treatment Options

Capsular contracture is one of the most common complications after breast augmentation or implant-based reconstruction. It can lead to changes in the feel, shape, or position of the breast — and in some cases, discomfort or pain.

The good news? Capsular contracture is completely treatable, especially when managed by an experienced plastic surgeon. In this guide, Dr. Ali Soueid explains what causes this condition, how to recognise the signs early, and the latest surgical options available for long-term correction.

What Is Capsular Contracture?

After a breast implant is placed, your body naturally forms a layer of scar tissue around it — known as a capsule. This is a normal immune response, and in most people, the capsule stays soft and flexible.

However, in some cases, the capsule becomes excessively tight or thickened, squeezing the implant and distorting the breast. This is known as capsular contracture.

What Causes It?

The exact cause isn’t always clear, but several factors may increase the risk of developing capsular contracture:

• • Bleeding or haematoma during or after surgery

• • Low-grade infection or bacterial contamination (biofilm)

• • Previous implant rupture or leakage

• • Radiotherapy after breast cancer surgery

• • Older-generation implants or textured surfaces

• • Genetic predisposition or autoimmune conditions

While any implant can develop a contracture, it’s more common with older implants, subglandular placement, or trauma to the area.

Signs and Symptoms of Capsular Contracture

Capsular contracture can occur weeks, months, or even years after breast augmentation or reconstruction. Symptoms often develop gradually.

Common signs include:

• • Breast firmness or hardening

• • Change in shape or roundness (appearing overly spherical or distorted)

• • Asymmetry between the breasts

• • Implant displacement or elevation

• • Tightness, aching, or even pain in the affected breast

In severe cases, the breast may feel rigid and unnatural.

Grading of Capsular Contracture (Baker Scale)

Plastic surgeons use the Baker Classification to assess the severity:

How Is It Diagnosed?

Dr. Ali Soueid performs a detailed clinical examination to assess firmness, symmetry, and breast shape. In some cases, ultrasound or MRI may be recommended to check:

• • The integrity of the implant

• • The thickness and extent of the capsule

• • Presence of fluid or silicone leakage (in case of rupture)

A clear diagnosis allows for accurate grading and individualised surgical planning.

Can Capsular Contracture Go Away on Its Own?

Unfortunately, once established, capsular contracture does not improve without intervention. In some early Grade II cases, non-surgical management (e.g. massage, medications like Singulair, or ultrasound therapy) may help — but for most moderate to severe cases, surgery is the definitive treatment.

Surgical Treatment Options

Dr. Soueid offers advanced revision techniques tailored to the severity and cause of your capsular contracture.

1. Capsulectomy (Total or Partial)

• • The scar capsule is removed surgically

• • Can be partial (anterior capsulectomy) or complete (total capsulectomy)

• • Often combined with implant replacement or removal

2. En Bloc Capsulectomy

• • The implant and capsule are removed together as a single unit

• • Preferred in cases of implant rupture, silicone leakage, or patient request

• • Requires meticulous dissection to preserve surrounding tissues

3. Implant Exchange

• • Many patients choose to replace the old implant with a newer-generation, smoother-surface implant

• • Option to change implant size or shape, or switch to fat transfer for a more natural look

4. Internal Pocket Reconstruction

• • Especially important if the implant has shifted or the pocket has distorted

• • Helps restore proper positioning and symmetry

New Advances in Preventing Recurrence

Dr. Soueid incorporates the latest techniques to reduce the risk of future contracture, including:

• • Acellular dermal matrix (ADM) reinforcement (e.g., Strattice® or SurgiMend®)

• • Pocket revision and implant repositioning

• • Use of smooth, cohesive gel implants

• • Meticulous sterile technique to reduce biofilm risk

• • Capsulotomy or internal scoring when total capsulectomy is not needed

Frequently Asked Questions

Can I get capsular contracture again after surgery?

Yes, but with modern techniques, the risk is greatly reduced. Your individual risk factors will be assessed in detail.

Is the surgery painful?

Most patients describe mild to moderate discomfort that is well managed with oral pain relief. Recovery time is usually shorter than primary augmentation.

Will my breasts look better after revision?

Yes. Surgery aims to restore a natural shape, softness, and symmetry, often improving both appearance and comfort.

Can I combine it with other procedures?

Absolutely. Capsular contracture surgery is often combined with:

• • Breast lift (mastopexy)

• • Implant size adjustment

• • Fat grafting for improved contour

Why Choose Dr. Ali Soueid?

As a consultant plastic surgeon with extensive experience in complex breast implant revision, Dr. Ali Soueid is known for:

• • Safe and meticulous technique in capsulectomy and implant revision

• • Expertise in treating rupture + contracture together

• • Focus on aesthetic outcomes and natural-looking breasts

• • Clinics in London, Doha, Dubai, and Beirut

• • Compassionate, private, and highly personalised care

Book a Consultation

If your breast implant feels firm, painful, or looks distorted, it may be due to capsular contracture. Expert help is available.

Book your consultation with Dr. Ali Soueid to explore your safest and most effective treatment options — and regain softness, symmetry, and peace of mind.