Breast surgery
Capsular Contracture Treatment
With a 95% success rate, Dr. Cassileth's approach to capsular contracture is one of the most effective in the country.
Overview
Capsular contracture occurs when the scar tissue that naturally forms around a breast implant tightens and hardens, squeezing the implant. The breast may feel firm, sit higher than it should, look distorted, or become painful. You may also see it called capsular contraction. Both names describe the same problem.
A little context helps. The capsule itself is normal: your body forms one around every implant, and in most women it stays soft and goes unnoticed. Capsular contracture is what happens when that capsule keeps tightening. It affects between 2.8% and 20.4% of breast augmentation patients2, which makes it one of the most common complications of implant surgery4. It is also one of the most frustrating, because it often comes back after treatment.
Dr. Cassileth has developed a comprehensive protocol for capsular contracture treatment that addresses the underlying causes, not just the symptoms. Her approach has a 95% success rate, meaning most patients she treats do not experience recurrence.
Who it's for
The right candidate.
- Women with hardened, painful, or distorted breasts due to capsular contracture
- Patients who had capsular contracture treated elsewhere and saw it return
- Women seeking a long-term solution, not a temporary fix
- Patients with early, mild contracture (Grade II) that may respond to non-surgical treatment
Technique
How it's done.
95% success rate. Dr. Cassileth's protocol addresses capsule, implant, and pocket, not just one piece of the puzzle.
Comprehensive approach. Capsular contracture treatment typically includes capsule removal, implant replacement, ADM placement, and careful pocket adjustment.
Addresses root causes. Factors like biofilm, implant texture, and placement are all considered and corrected.
What the surgery involves. In plain terms, the hardened capsule comes out and a new implant goes in. A layer of acellular dermal matrix (ADM) supports the implant like an internal bra, and the pocket is reshaped so the implant sits where it should. The capsule is tested for biofilm, and the pocket is treated with antibiotic solution to lower the risk of infection.
Capsular Contracture Symptoms and Grades
Capsular contracture symptoms tend to creep in. One breast starts to feel different from the other, and over weeks or months the difference becomes hard to ignore. The most common signs of capsular contracture are:
- Firmness or tightness in one or both breasts
- A breast that sits higher on the chest or looks rounder than before
- A change in shape, or visible distortion
- Unevenness between the two sides
- Pain, tenderness, or a steady ache
About three in four cases appear within two years of surgery3, although symptoms of capsular contracture can also show up many years later. If any of this sounds familiar, an exam is the quickest way to know whether capsular contraction is the cause.
Baker Grades of Capsular Contracture
Surgeons rate the severity of capsular contracture on the Baker scale, from Grade I to Grade IV.
| Grade | How the breast feels | How it looks | What it usually means |
|---|---|---|---|
| Grade I | Soft and natural | Normal | The capsule is behaving as it should. No treatment is needed. |
| Grade II | Slightly firm | Normal | Early contracture. Monitoring, and sometimes non-surgical treatment. |
| Grade III | Firm | Visibly abnormal: overly round, hard-looking, or misshapen | Established contracture. Surgery is the reliable fix. |
| Grade IV | Hard, tender, and painful | Misshapen and often displaced on the chest | Severe contracture. Surgery is recommended. |
Is Capsular Contracture Dangerous?
Is capsular contracture dangerous? Usually not. For most women it is a problem of comfort and appearance: firmness, distortion, and sometimes pain. It does not raise your risk of breast cancer.
The real risks sit at the severe end of the scale. A capsule can tighten enough to rupture the implant, and a breast that has shifted position can make mammograms harder to perform.
Call your surgeon promptly if you notice:
- A sudden change in shape, height, or hardness
- Pain with redness, warmth, or fever
- New swelling or drainage
Those signs can point to an infection or, rarely, to another implant-related condition that resembles contracture. And because contracture so often returns after an incomplete repair, how it is treated matters as much as when.
What to expect
From consultation to recovery.
Before Surgery
- Consultation. Evaluate your contracture grade, implant history, and contributing factors.
- Imaging. MRI or ultrasound may be used to assess capsule thickness and implant condition.
During Surgery
- Capsulectomy. The hardened capsule is removed completely.
- Implant replacement. A new implant is placed in an optimized pocket with ADM support.
- Pocket modification. The implant pocket is adjusted to prevent recurrence.
After Surgery
- Recovery. Similar to standard implant surgery. Most patients return to activity within 1 to 2 weeks.
- Timeline. Drains come out around days 5 to 7. Scar care starts at week 3, and the compression bra stays on for 6 weeks.
- Monitoring. Regular follow-up to make sure the contracture has not returned.
“Replacing the implant without addressing the capsule significantly increases recurrence. The capsulectomy is the operation; the implant exchange is the finish.”
Dr. Lisa Cassileth
Patient results
Real cases.
Capsular contracture rarely arrives alone, and it often returns after an incomplete repair. Each patient below came in with a second problem or a history of failed surgery, and each was corrected in a single plan.
Beverly Hills. Capsular contracture and a ruptured implant on her left side. She also felt her original implants sat too far toward the sides. Dr. Cassileth removed and replaced her silicone implants.
Sherman Oaks. Saline implants placed nearly 20 years earlier. She developed Grade IV capsular contracture in her left breast, while her right implant had bottomed out.
Calabasas. In her 30s, after four previous revision surgeries for capsular contracture. Dr. Cassileth removed and replaced her implants, using silicone implants and ADM.
Insurance
Read about coverage & financing →Capsular contracture treatment may be covered by insurance, especially when the original surgery was for reconstruction. Our Patient Advocacy team verifies your benefits, pursues authorization on your behalf, and gives you a written estimate before you commit. If your plan does not cover it, financing is available.
FAQ
Common questions.
What is capsular contracture?
Capsular contracture is a complication of breast implant surgery in which the scar tissue capsule around an implant tightens and hardens. The breast can feel firm, look distorted, or become painful. It is sometimes called capsular contraction, and it can follow either breast augmentation or implant-based reconstruction.
How common is capsular contracture?
Capsular contracture is one of the most common complications of breast implant surgery. Published rates range from 2.8% to 20.4% of breast augmentation patients2, and the American Society of Plastic Surgeons puts it at roughly one in six3. About three quarters of cases appear within two years of surgery.
Is capsular contracture dangerous?
Capsular contracture is not typically dangerous. Its main effects are firmness, a distorted shape, and sometimes pain. It can become a health risk when the capsule tightens enough to rupture the implant. Sudden swelling, redness, warmth, or fever needs a prompt call to your surgeon.
Does capsular contracture hurt?
It can. Early capsular contracture often causes firmness without pain. As the capsule tightens, the breast may ache or feel tender, and Grade IV contracture, the most severe on the Baker scale, is usually painful. Pain that comes on suddenly should be checked promptly.
What causes capsular contracture?
No single cause explains every case. Known contributors include bacterial biofilm on the implant1, bleeding or fluid around it after surgery, implant rupture, radiation, and a previous contracture. Our guide explains how to prevent capsular contracture and why some patients are more prone to it.
Can you prevent capsular contracture?
You cannot prevent capsular contracture entirely, but you can lower the risk. Surgical technique matters most: careful implant handling, antibiotic irrigation of the pocket, and implant placement all play a part. On your side, stopping nicotine, following aftercare instructions, and keeping follow-up visits all help.
Can capsular contracture be treated without surgery?
Sometimes, in mild cases. Early, lower-grade contracture may be monitored or treated with medication that calms inflammation. Established capsular contracture, where the breast is visibly distorted or painful, needs surgery to remove the capsule. Dr. Cassileth will tell you which applies once she has examined you.
Do you have to remove implants to fix capsular contracture?
Yes. Capsular contracture can only be cured when the entire capsule is removed, and because the capsule surrounds the implant, the implant comes out with it. The same implant could be placed back, but Dr. Cassileth generally prefers a brand new one.
Can capsular contracture come back after treatment?
It can. Traditional methods of correcting capsular contracture often lead to recurrence. Dr. Cassileth's revision protocol removes the capsule completely, replaces the implant, and supports it with ADM, and it has a success rate of 95%. Regular follow-up visits catch any early change.
Related reading
From the journal.
Sources
Cited research.
- 1Ajdic D, Zoghbi Y, Gerth D, et al. The Relationship of Bacterial Biofilms and Capsular Contracture in Breast Implants. Aesthet Surg J. 2016;36(3):297-309.
- 2Headon H, Kasem A, Mokbel K. Capsular Contracture after Breast Augmentation: An Update for Clinical Practice. Arch Plast Surg. 2015;42(5):532-543. doi:10.5999/aps.2015.42.5.532. pmc.ncbi.nlm.nih.gov · Accessed October 13, 2026
- 3American Society of Plastic Surgeons. What is capsular contracture and how can it be treated? plasticsurgery.org · Accessed October 13, 2026
- 4U.S. Food and Drug Administration. Risks and Complications of Breast Implants. fda.gov · Accessed October 13, 2026
Ready to discuss capsular contracture treatment?
Schedule a consultation with Dr. Cassileth and her team to have your capsular contracture symptoms examined and your options explained.
Request a consultation