Updated for 2026
Capsular contracture is a complication that can develop following breast augmentation. It happens when your body’s immune system creates tight, contracting scar tissue around your breast implants, which can result in a misshapen appearance or discomfort.
If you notice any of these five early symptoms of capsular contracture, let us know so we can provide you with an accurate diagnosis and treatment solution.
What Is Capsular Contracture?
Every breast implant sits inside a layer of scar tissue, called a capsule, that forms naturally as part of the healing process. In most women, this capsule stays thin and flexible, so the implant feels soft and moves naturally. Capsular contracture develops when that scar tissue thickens and tightens around the implant instead.
Who Gets Capsular Contracture?
Capsular contracture can happen to anyone with breast implants, but a few factors raise the odds. Bacteria introduced during surgery can trigger the immune system to build up excess scar tissue, and a history of hematoma, seroma or infection after surgery adds to the risk.
Smoking slows healing and increases your chances as well, which is why Dr. Castellano and Dr. Giglio ask that all cosmetic surgery patients stop smoking for several weeks before and after their procedures.
Implant rupture is also a common cause of contracture that develops years after the original surgery. However, most cases of capsular contracture occur within the first two years after breast augmentation surgery.
Early Signs of Capsular Contracture
Capsular contracture usually develops gradually rather than overnight, so knowing what to watch for can help you catch it early. Here are five changes to look out for.
1. Your Implants Are “Riding High”
“Riding high” refers to the high position of breast implants on your chest wall. While this can be very normal in the first few weeks after your breast enhancement procedure, implants that appear to sit higher than normal once they’ve already settled into their final position may indicate capsular contracture.
2. Your Breasts Feel Tight or Uncomfortable
Keep in mind that some tightness or discomfort during your first stages of recovery can be normal.
Because capsular contracture happens when capsules of collagen fibers in your body become very tightly woven around your implants, you may notice a tight or even painful sensation in this area. This discomfort is typically worsened when lying flat on your stomach.
If you notice these symptoms during your breast augmentation recovery, be sure to let your cosmetic surgeon know so that he or she can determine whether or not your body is healing as it should be.
3. A Very Round or Rippled Appearance
The added pressure on your breast implants that results from tightening scar tissue can lead to a very round, ball-like appearance or a rippled or waved effect. These, along with a hardened feeling, are often early symptoms of capsular contracture and may require revision surgery to correct.
4. Your Breast Feels Hard or Firm to the Touch
As the scar tissue tightens, your breast may start to feel firm or even hard instead of soft and pliable. This firmness is one of the main signs we use to determine the severity of capsular contracture, and it often shows up alongside some of the other symptoms on this list, like a rounded shape or noticeable tightness.
5. You Notice New Pain or a Change in Symmetry
Some tenderness after breast augmentation is normal, but new or worsening pain months or years later is not. As the scar tissue tightens, it can pull on surrounding breast tissue and cause an ache or sharp discomfort. Capsular contracture can also affect one breast more than the other, so if your breasts start to look or feel different from each other, let us know.
Can Capsular Contracture Be Prevented?
There is no guaranteed way to prevent capsular contracture, but a few things can lower your risk.
- Choosing an experienced cosmetic surgeon who uses careful surgical technique and minimal implant handling.
- Submuscular implant placement, meaning the implant sits beneath the chest muscle rather than above it.
- Quitting smoking before surgery and following your surgeon’s post-operative instructions closely can support proper healing as well.
What to Do If You Think You Might Have Capsular Contracture
If you notice any of these signs, do not wait for them to resolve on their own, since capsular contracture will not improve without treatment. Contact your cosmetic surgeon so they can examine your breasts and determine the right next step, whether that is monitoring, medication or surgical correction.
Dr. Castellano, Dr. Giglio and the team at Castellano Cosmetic Surgery Center have extensive experience treating capsular contracture in Tampa. If you are noticing any of these symptoms, contact our office or call us at 813-872-6093 to schedule a consultation.
Author: Dr. Joseph Castellano
Dr. Joseph Castellano is a native Floridian who grew up in the Tampa Bay area. After medical school and residency, Dr. Castellano returned home and has opened a practice in Tampa, Florida focusing on breast augmentation, abdominoplasty, liposuction, facelift, and eyelid rejuvenation. He is a member of the American Board of Cosmetic Surgery, American College of Surgeons, and American Medical Association
