Asymmetry and Firm Implants due to Capsular Contracture

About 20 percent of women will desire adjustment of their implants after breast augmentation. The most common reasons include switching to a different implant size, asymmetry, implant mal-position, and capsular contracture.

Capsular contracture is a condition where the scar tissue around a breast implant becomes abnormally thick. Capsular contracture can make the implant uncomfortable, and feel hard to the touch. The thickened scar can squeeze the implant causing a change in the shape of your breast, or it can alter the position of the implant, resulting in breast asymmetry.

The exact causes of capsular contracture are not known. There is some evidence that it is linked to subclinical (low-grade) infection around the implant, bleeding in the area of the implant, and by the body’s reaction to foreign substances (to silicone, for example). Capsular contracture can also be caused by an implant rupture. If your implant has looked and felt great for some time, but now your breast shape has changed or the tissue has become very firm, you could have an implant rupture. A breast MRI can determine if the silicone implant is compromised.

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Capsular contracture is treated by surgery – removal of the implant, and cutting or removing the scar tissue in multiple places. Then, the same implant or a new one is placed into the breast. If the implant was previously on top of the muscle, it will likely be repositioned behind the muscle to reduce the risk of forming a tight capsule again. If contracture is caused by a ruptured silicone implant, then the entire capsule and implant will be removed (total capsulectomy), and a new implant placed.

Capsulectomy and implant replacement improve the appearance and symmetry of your breasts and make them soft again. However, patients who have had a capsular contracture are at a higher risk of forming it again (compared to a patient that has never had this condition).


If you are troubled by capsular contracture, you may need a breast augmentation revision. The cost of new implants will be covered by the manufacturer if there is a defect.

Call today to schedule an evaluation to determine if you need breast revision surgery in Los Angeles.

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Dr. Dennis Dass

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