What is Capsular Contracture (Implant Hardening)? - Dr Mark Kohout

What is Capsular Contracture (Implant Hardening)?

Capsular contracture is a relatively common issue with breast implants, where the scar tissue around the implant becomes unusually hard. The ‘capsule’ is your own scar tissue which forms as part of the body’s natural response to the foreign material of the breast implant. It helps keep the implant in place, but over time, the scar capsule can become very hard and tighten around the implant causing pain, discomfort and the implant to move.  


Initially, all you may notice is that one of your breasts feels slightly firmer than the other. This may not present as a serious issue, but as the capsular contracture tightens further, you may notice other additional symptoms. The next stage in the progression of capsule contracture is constant discomfort in the breast which feels like tightness, pulling or tension. 


When a capsular contracture becomes severe it can actually change the shape of your breast. On one side the implant may sit higher than the other, making your upper breast bulge and be noticeably uneven. When a capsular contracture reaches this stage and it affects both your comfort and the overall appearance of your breasts, I generally recommend removing the implant completely and then replacing the implant with a new one. Very occasionally, removal and replacement of both sides is required.


Below is an example of capsular contracture. You can see the unevenness between the two implants which has then been significantly improved with the placement of new implants.