21 Jul 2026 | by Sean Doherty, MD, FACS
Over 300,000 breast augmentations are performed annually in this country alone, making it one of the most popular aesthetic procedures in the world. In general, most patients who see a Board-Certified Plastic Surgeon with extensive experience in breast surgery, such as myself, do not develop significant complications with their breast implants. However, capsular contracture, which is a hardening of the capsular tissue that your body naturally forms around any foreign device, is always a potential risk. I spend considerable time during our initial consultation and pre-op meetings going over your medical history, your body's reaction to any prior surgeries and your lifestyle in order to help determine your individual risk factor. While there are steps that you can take to reduce said risk, the most important being your choice of surgeon, if you do develop a complication, here are some steps that I generally recommend for managing capsular contracture.
What Causes Capsular Contracture?
Capsular contracture is a condition in which the scar tissue or capsule that the body naturally develops to surround any foreign device becomes hard, thick and tight. This unnatural tightening presses on your breast implant which distorts breast shape, doesn't feel right and, in severe cases, can be quite painful. The problem with capsular contracture is that we still don't know exactly why an implant triggers an overblown immune response in one woman's body but not another. However, we do know that there are certain factors that can increase your risk such as:
- Nicotine use
- Periareolar incision
- Bacteria on the implant
- History of radiation treatment
- Complication in the healing process such as hematoma
- Type of breast implant
The single greatest thing that you can do to ensure an exemplary aesthetic result that will stand the test of time is to schedule a consultation with an experienced surgeon. I've successfully placed hundreds of breast implants in my Boston area patients and thus have a deep understanding of what could put you a risk as well as the pros and cons of all the various breast implants.
Capsular Contracture Treatment Options
If you think that you have capsular contracture, you want to schedule an appointment with either your original surgeon or another qualified plastic surgeon in your area to be examined in person. In general, if I see a patient who has capsular contracture that has just started then using an anti-inflammatory oral medicine may prevent the contracture from getting worse. If the capsule has been there for awhile then my recommendation is to remove the breast implant and replace it with a new implant in a new pocket. The latter may be a breast implant from a different manufacturer. For example, Motiva breast implants tend to cause less of an inflammatory reaction, making them a potentially better choice for women with capsular contracture. In addition to revision breast surgery to change your actual implants, I may also modify their placement. In those patients whose implants were placed sub-glandularly, I will now typically situate the new breast implants under the muscle. Starting about 2 weeks after your revision surgery, I will have you start displacement exercises in order to promote implant mobility and keep the tissue of the pocket flexible. For some patients, I may also recommend Accolate, also known as Zafirlukast, starting 3 months post-op. This is an asthma medication that has proven to also be effective for decreasing the inflammatory response of capsular contracture.
To find out more about capsular contracture and revision breast surgery, or any other surgical or non-surgical procedure with Dr. Sean Doherty at Boston Center for Plastic Surgery, contact us today or call (617) 450-0070 to schedule a consultation.
