Breast implants are usually made of silicone and as such, are a foreign material within the body. The body’s response is to wall the implants off in a layer of specialised scar tissue. This is known as a capsule.

All women with breast implants develop a capsule to a certain degree. Only if the capsule becomes thickened and problematic do we call this a capsular contracture or encapsulation.

This causes hardening and usually requires a replacement operation. It occurs in approximately 10% of patients in the first five years after breast implant surgery.

Although there are several generally agreed on factors, a specific cause of capsular contracture has not been found. Research has suggested that biofilms (a thin but robust layer sticking to a solid surface and containing a community of bacteria and other microorganisms), infection, haematoma (blood collection), implant rupture, and irradiation (x-ray treatment) may be possible causes of capsular contracture.

Capsular contracture is grouped into 4 different categories

Grade 1 – Normal soft implants

Grade 2 – Hardening around the implant that you can feel

Grade 3 – Hardening around the implant that is visible and may change the shape of the breast

Grade 4 – Painful contracture

Capsular contracture is normally treated with surgery. Primarily, this involves exchanging your breast implants and removal of the capsular contracure. It may also require changing the location of the implant, for example, from on top of the muscle (sub-glandular) to below the muscle (sub-pectoral).

Breast implant problems

Once you have developed capsular contracture there is an increased risk of it recurring even with surgery to correct it. There is no urgency or timescale in getting capsular contracture treated and it depends entirely on how problematic the contracture is for you and how soon you want to get it treated.

Breast implant problems, ALCL & BII