Understanding Capsular Contracture: A Comprehensive Guide

What Is Capsular Contracture?

Capsular contracture is a condition where the body’s natural scar tissue, known as the “capsule,” around a breast implant becomes unusually thick, tight, or hardened. This tightening can compress the implant, affecting both comfort and appearance. Instead of remaining thin and flexible, the capsule contracts—sometimes significantly.

Individuals with capsular contracture often describe their breasts as too firm, too round, too high-set, distorted, or painful. This condition can affect one or both breasts and may develop months or even years after surgery.

Common Symptoms of Capsular Contracture

Recognizing the symptoms early is crucial. Here are some common signs to watch for:

• Firm or unusually hard breast tissue

• Tightness or pressure around the implant

• Pain, discomfort, or tenderness

• A high-set or overly round appearance

• Misshapen nipples or visible asymmetry

  
  

The Four Stages of Capsular Contracture (Baker Grades I–IV)

Understanding the progression of capsular contracture can help clients recognize early signs and know when to seek care. The medical community uses the Baker Scale to classify the severity of capsular contracture from Grade I to Grade IV.

⭐ Grade I – Normal Soft Capsule

At this stage, a thin, flexible capsule has formed around the implant — this is normal and expected.

What it feels like:

• Breast looks natural

• Soft, no tightness

• No pain

  
  

What it means: The implant pocket is healthy, mobile, and functioning normally.

⭐⭐ Grade II – Slight Firmness

The capsule begins to tighten slightly, but the breast still looks normal.

What it feels like:

• Mild firmness

• Slight increase in pressure

• No visible distortion

  
  

What it means: This is considered an early capsular change. Many clients don’t realize anything is happening yet.

⭐⭐⭐ Grade III – Moderate/Obvious Contracture

The capsule has thickened enough to change the appearance of the breast.

What it feels like:

• Noticeable firmness

• Visible distortion (more round, high, or misshapen)

• Typically not painful yet

  
  

What it means: The tightening has progressed enough to alter the implant shape. Supportive therapies may help the surrounding tissue feel more comfortable, but medical assessment is important.

⭐⭐⭐⭐ Grade IV – Severe Contracture

The capsule is very tight and rigid, causing pain and significant distortion.

What it feels like:

• Breast is hard

• Painful or tender

• Strong distortion or shifting

• Coldness or pulling sensations

  
  

What it means: This is the most severe form and usually requires surgical correction. Supportive therapies (massage, FSM, Avazzia microcurrent) may help with discomfort in the surrounding tissue but cannot replace medical treatment.

Why These Stages Matter

Understanding the Baker grades helps clients:

• Recognize early symptoms

• Seek care before symptoms worsen

• Distinguish normal post-op firmness from true contracture

• Know when supportive therapies may help with comfort, mobility, or inflammation

  
  

Causes of Capsular Contracture

While the exact cause isn’t fully understood, several factors may contribute:

Bacterial Contamination and Biofilm Formation

Microscopic bacteria introduced during surgery can trigger an inflammatory response, increasing scar tissue formation.

Implant Rupture

Leakage from a silicone implant can irritate surrounding tissues and lead to capsular tightening.

Radiation Therapy

Radiation significantly affects tissue health and increases the likelihood of scar tissue complications.

Other Factors

Genetic predisposition, immune system response, and individual healing patterns may also play a role.

How Biofilm and Contracture Are Linked

• Introduction of bacteria: Bacteria can be introduced to the implant site during the surgery.

• Formation of biofilm: Bacteria form a protective biofilm, a community encased in a sticky matrix that shields them from the body's immune response and antibiotics.

• Chronic inflammation: The persistent presence of this biofilm triggers a chronic inflammatory reaction.

• Scar tissue formation: The body's response is to create a thick, fibrous scar tissue capsule around the implant to wall it off.

• Capsular contracture: As this scar tissue capsule hardens and thickens, it squeezes the implant, leading to capsular contracture.

  
  

Signs and Symptoms

• The breast may feel hard or tight.

• Pain, tightness, or discomfort are common.

• The shape of the breast may become distorted, and the implant might look misshapen or be positioned abnormally.

  
  

Treatment

• Because the biofilm protects the bacteria, antibiotics are usually ineffective.

• The standard treatment is surgical removal of the implant and the entire scar tissue capsule (capsulectomy).

• This is often followed by implant replacement.

  
  

Prevention

While prevention isn’t guaranteed, several strategies may lower risk:

1. Regular Breast Massage

Gentle, consistent massage helps maintain movement within the implant pocket and may discourage excessive tightening in the early months after surgery.

2. Surgical Techniques

• Polyurethane-coated implants

• Submuscular placement

• Textured implants - These may reduce the risk in some patients.

  
  

Treatment Options for Capsular Contracture

Surgical Correction (Standard Treatment)

• Capsulectomy: Removal of the capsule and implant

• Capsulotomy: Cutting the capsule to release tightness

• En Bloc Capsulectomy: Removing the implant and entire capsule as one unit

  
  

Other Medical Approaches

Depending on the surgeon, these capsular contracture treatments may include medications, acellular dermal matrices, or additional interventions.

Important Note: Even with surgery, recurrence is possible. A medical professional should always be consulted for diagnosis and treatment.

How Massage, FSM, and Avazzia Microcurrent May Support Individuals With Capsular Contracture

While massage and microcurrent are not medical treatments for capsular contracture and cannot replace surgical intervention, many clients seek complementary care to support comfort, mobility, and tissue health. Here’s how these modalities may help before or after medical evaluation, or as supportive therapy between medical appointments.

Massage Therapy

Gentle, specialized massage techniques may help:

• Improve circulation and lymphatic flow

• Support softer, more mobile tissue

• Reduce discomfort from tight fascia

• Improve awareness and mobility around the chest wall

• Support the body’s natural healing environment

  
  

Massage does not reverse severe contracture, but it may help maintain healthier tissue texture and comfort, especially in early stages or post-treatment with provider approval.

Frequency Specific Microcurrent (FSM)

FSM uses specific frequencies and micro-amp electrical currents to target different tissues. Clients with capsular contracture may experience benefits such as:

• Reduced inflammation

• Softer, more pliable fascial tissue

• Decreased discomfort or hypersensitivity

• Support for the lymphatic and immune systems

• Improved movement in surrounding musculature

  
  

Some frequencies used in supportive care include those targeting scar tissue, fibrosis, inflammation, and lymphatic flow. FSM is commonly used across 6–15 sessions, depending on tissue density and individual response.

Avazzia Microcurrent

Avazzia devices use feedback-based microcurrent technology that interacts directly with the nervous system and fascia. Possible supportive benefits include:

• Soothing inflamed or tight tissue

• Encouraging more natural tissue repair signals

• Softening fibrotic or bound-down fascia

• Improving comfort and reducing guarding patterns

• Supporting improved lymphatic drainage

  
  

Clients often describe the experience as gentle, warm, and relaxing, with a noticeable change in tissue texture over repeated sessions.

What to Expect During a Session

A combined massage + microcurrent session may include:

• Intake and assessment of tissue mobility and symptoms

• Gentle manual work to encourage circulation and reduce tightness

• Targeted FSM frequencies for inflammation, fibrosis, or scar tissue

• Avazzia microcurrent applied to the chest wall, lymph drainage pathways, and supportive tissues

• A calm, pain-free experience—most clients find microcurrent deeply relaxing

  
  

Sessions typically last 60–90 minutes, and many clients notice changes in comfort or tissue texture after several visits.