{"id":23594,"date":"2026-05-06T12:00:00","date_gmt":"2026-05-06T12:00:00","guid":{"rendered":"https:\/\/www.doctoraso.es\/blog\/capsular-contracture-symptoms-baker-grades-and-treatment\/"},"modified":"2026-09-29T19:05:02","modified_gmt":"2026-09-29T19:05:02","slug":"capsular-contracture-symptoms-baker-grades-and-treatment","status":"publish","type":"post","link":"https:\/\/www.doctoraso.es\/en\/blog\/capsular-contracture-symptoms-baker-grades-and-treatment\/","title":{"rendered":"Capsular Contracture: Symptoms, Baker Grades and Treatment"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row css=&#8221;.vc_custom_1751024304581{margin-top: 15px !important;}&#8221; css_params=&#8221;&#8221;][vc_column][vc_column_text css=&#8221;&#8221; css_params=&#8221;&#8221;]<\/p>\n<article class=\"aso-contracture\">\n<header class=\"aso-contracture__header\">\n  <span class=\"aso-contracture__eyebrow\">A medical guide to breast implants<\/span><\/p>\n<p class=\"aso-contracture__lead\">Capsular contracture develops when the capsule of scar tissue that normally forms around a breast implant becomes thicker and tightens more than expected. It can make the breast feel firm or change its shape and, in more advanced cases, cause pain. Not every painful, swollen or changed breast after implant surgery has capsular contracture. A change that develops years later, in particular, should be assessed before a diagnosis is assumed.<\/p>\n<\/header>\n<section class=\"aso-contracture__answer\" aria-labelledby=\"aso-contracture-respuesta\">\n<div>\n<h2 id=\"aso-contracture-respuesta\">What is capsular contracture?<\/h2>\n<p>Every breast implant becomes surrounded by a thin capsule of scar tissue. This is a normal part of healing and is not a complication when the capsule remains soft.<\/p>\n<p>We use the term <strong>capsular contracture<\/strong> when the capsule becomes unusually firm and compresses the implant. It can affect one or both breasts and may appear in the first few months or develop years after surgery.<\/p>\n<p><strong>In brief:<\/strong> you may suspect capsular contracture if a breast gradually becomes firmer, sits higher, looks rounder or changes shape, especially if it is painful. An examination is needed because a firm or painful breast can also be caused by a seroma, implant rupture, infection or implant displacement.<\/p>\n<\/p><\/div>\n<ul class=\"aso-contracture__answer-list\">\n<li>A thin, soft capsule is normal<\/li>\n<li>Baker grade I is not pathological<\/li>\n<li>Firmness may be accompanied by a change in shape or pain<\/li>\n<li>Baker grades III and IV are the most clinically significant<\/li>\n<li>Diagnosis is primarily clinical<\/li>\n<\/ul>\n<\/section>\n<details class=\"aso-contracture__toc\">\n<summary>Explore this guide<\/summary>\n<nav aria-label=\"Article contents\">\n    <a href=\"#capsula-normal-contractura\">Normal capsule or contracture<\/a><br \/>\n    <a href=\"#grados-baker\">Baker grades<\/a><br \/>\n    <a href=\"#sintomas-contractura\">Symptoms and warning signs<\/a><br \/>\n    <a href=\"#frecuencia-contractura\">How common is it?<\/a><br \/>\n    <a href=\"#causas-riesgo\">Causes and risk factors<\/a><br \/>\n    <a href=\"#reducir-riesgo\">Reducing the risk<\/a><br \/>\n    <a href=\"#diagnostico-contractura\">Diagnosis<\/a><br \/>\n    <a href=\"#tratamiento-contractura\">Treatment<\/a><br \/>\n    <a href=\"#protocolo-contractura\">Our approach<\/a><br \/>\n    <a href=\"#fotos-contractura\">Photos of a real case<\/a><br \/>\n    <a href=\"#preguntas-contractura\">Frequently asked questions<\/a><br \/>\n  <\/nav>\n<\/details>\n<section class=\"aso-contracture__section\" id=\"capsula-normal-contractura\">\n<h2>A normal capsule versus capsular contracture<\/h2>\n<p class=\"aso-contracture__section-intro\">The word \u201ccapsule\u201d can sound alarming, but every implant has one. The important distinction is between a normal capsule and one that has become clinically problematic.<\/p>\n<div class=\"aso-contracture__comparison\">\n<section class=\"aso-contracture__card aso-contracture__card--normal\">\n<h3>Normal capsule<\/h3>\n<ul>\n<li>It is thin and flexible.<\/li>\n<li>The breast feels soft.<\/li>\n<li>The implant retains a natural position and shape.<\/li>\n<li>It does not cause pain or visible distortion.<\/li>\n<\/ul>\n<\/section>\n<section class=\"aso-contracture__card aso-contracture__card--contracture\">\n<h3>Capsular contracture<\/h3>\n<ul>\n<li>The capsule thickens, hardens or tightens.<\/li>\n<li>The breast may gradually feel firmer.<\/li>\n<li>The implant may appear higher, rounder or distorted.<\/li>\n<li>Pain can occur in advanced cases.<\/li>\n<\/ul>\n<\/section><\/div>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"grados-baker\">\n<h2>Baker grades of capsular contracture<\/h2>\n<p class=\"aso-contracture__section-intro\">The Baker scale classifies breast firmness and visible changes assessed during an examination. It helps guide treatment, although it is a clinical assessment and different examiners may grade the same breast differently.<\/p>\n<div class=\"aso-contracture__grades\">\n<section class=\"aso-contracture__grade aso-contracture__grade--normal\" data-grade=\"I\">\n<h3>Grade I<\/h3>\n<p>The breast is soft and looks natural. This is the normal state around an implant and is not considered pathological contracture.<\/p>\n<\/section>\n<section class=\"aso-contracture__grade\" data-grade=\"II\">\n<h3>Grade II<\/h3>\n<p>The breast feels somewhat firmer but still looks normal. If it remains stable and causes no discomfort, monitoring may be sufficient.<\/p>\n<\/section>\n<section class=\"aso-contracture__grade aso-contracture__grade--severe\" data-grade=\"III\">\n<h3>Grade III<\/h3>\n<p>The breast is firm and has a visible change in shape or position. Treatment is considered according to the deformity and symptoms.<\/p>\n<\/section>\n<section class=\"aso-contracture__grade aso-contracture__grade--severe\" data-grade=\"IV\">\n<h3>Grade IV<\/h3>\n<p>The breast is hard, distorted and painful. This is the most advanced grade and often requires revision surgery.<\/p>\n<\/section><\/div>\n<aside class=\"aso-contracture__note\">\n<h3>An ultrasound cannot assign a Baker grade on its own<\/h3>\n<p>Ultrasound is valuable for assessing the implant and looking for fluid, rupture or other complications, but Baker grading is based mainly on the examination and appearance of the breast.<\/p>\n<\/aside>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"sintomas-contractura\">\n<h2>Symptoms of capsular contracture<\/h2>\n<p>The most typical symptoms are <strong>progressive firmness<\/strong>, reduced implant mobility, a feeling of tightness and changes in breast shape. The breast may look higher, rounder or asymmetric. Pain is more typical of advanced grades.<\/p>\n<p>One breast feeling slightly firmer than the other does not, by itself, confirm contracture. Differences may also be caused by the amount of breast tissue, muscle, pre-existing asymmetry, implant position, rupture or a collection of fluid.<\/p>\n<p><strong>Prompt assessment helps identify the cause before attributing the change to contracture.<\/strong> Early assessment cannot guarantee that surgery will be avoided, but it helps distinguish early contracture from seroma, rupture, infection or implant malposition and supports timely treatment decisions.<\/p>\n<h3>A firm breast does not always mean contracture<\/h3>\n<div class=\"aso-contracture__table-wrap\" role=\"region\" aria-label=\"Differences between capsular contracture symptoms and other complications\" tabindex=\"0\">\n<table class=\"aso-contracture__differential\">\n<thead>\n<tr>\n<th scope=\"col\">What you notice<\/th>\n<th scope=\"col\">What it may suggest<\/th>\n<th scope=\"col\">What to do<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<th scope=\"row\">Gradual firmness, a higher position or a rounder shape<\/th>\n<td data-label=\"What it may suggest\">Capsular contracture<\/td>\n<td data-label=\"What to do\">Clinical examination and ultrasound to assess the implant and rule out other causes.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Sudden swelling of one breast<\/th>\n<td data-label=\"What it may suggest\">Seroma, bleeding or inflammation<\/td>\n<td data-label=\"What to do\">Seek assessment without delay; a late fluid collection requires ultrasound-guided aspiration and specific testing.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">New pain years after surgery<\/th>\n<td data-label=\"What it may suggest\">Contracture, rupture, inflammation or another breast or muscle condition<\/td>\n<td data-label=\"What to do\">Do not assume the diagnosis: have an examination and imaging when indicated.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">Redness, warmth or fever<\/th>\n<td data-label=\"What it may suggest\">Infection or inflammation<\/td>\n<td data-label=\"What to do\">Seek prompt medical advice to rule out a complication requiring treatment.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">A change in shape or position<\/th>\n<td data-label=\"What it may suggest\">Contracture, malposition or rupture<\/td>\n<td data-label=\"What to do\">Compare both breasts and assess the capsule, implant pocket and implant integrity.<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n<aside class=\"aso-contracture__warning\">\n<h3>Seek assessment promptly if you notice any of these changes<\/h3>\n<ul>\n<li>Sudden swelling of one breast.<\/li>\n<li>Late-onset swelling or fluid around the implant.<\/li>\n<li>Redness, fever or local warmth.<\/li>\n<li>A lump in the breast, capsule or armpit.<\/li>\n<li>New, severe or worsening pain.<\/li>\n<li>A sudden change in shape or implant position.<\/li>\n<\/ul>\n<p>These signs do not necessarily mean that you have a serious condition, but they call for examination and imaging to distinguish contracture from seroma, infection, rupture, malposition and other, less common complications.<\/p>\n<\/aside>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"frecuencia-contractura\">\n<h2>How common is capsular contracture?<\/h2>\n<p>Capsular contracture is <strong>one of the more significant long-term complications and a common reason for revision surgery<\/strong> after breast augmentation. That does not mean there is one percentage that applies to every patient.<\/p>\n<p>Published rates vary with the indication\u2014cosmetic augmentation or reconstruction\u2014the type and surface of the implant, its placement, radiotherapy, postoperative complications, the definition used and, especially, the length of follow-up. It would therefore be misleading to turn a single figure into a personal guarantee.<\/p>\n<p>Careful planning and technique can reduce the risk, but cannot eliminate it. When a clinic or implant manufacturer reports outcomes, the number of patients, Baker grade counted, losses to follow-up and duration of observation also matter.<\/p>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"causas-riesgo\">\n<h2>Why does it happen? Causes and risk factors<\/h2>\n<p>Capsular contracture is <strong>multifactorial<\/strong>. A patient&#8217;s inflammatory and healing response, implant characteristics, the environment of the implant pocket and events such as a hematoma, seroma or infection may all play a part. Low-virulence bacteria and biofilm have also been investigated as possible contributors, but they do not explain every case.<\/p>\n<div class=\"aso-contracture__factor-grid\">\n<section class=\"aso-contracture__card\">\n<h3>Clinical factors<\/h3>\n<ul>\n<li>A previous capsular contracture.<\/li>\n<li>Breast reconstruction and radiotherapy.<\/li>\n<li>Longer time since implantation.<\/li>\n<li>Individual healing response.<\/li>\n<\/ul>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>Implant-pocket complications<\/h3>\n<ul>\n<li>Postoperative bleeding or hematoma.<\/li>\n<li>Seroma around the implant.<\/li>\n<li>Clinical infection or bacterial contamination.<\/li>\n<li>Implant rupture in some cases.<\/li>\n<\/ul>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>Implant placement<\/h3>\n<p>In cosmetic augmentation, some meta-analyses have associated subpectoral placement with less contracture than prepectoral placement. However, the studies are heterogeneous, do not necessarily reach the same conclusion for reconstruction and do not always compare equivalent implants or techniques.<\/p>\n<p>We therefore do not regard placement beneath the muscle as universally better. We choose between subglandular, subfascial, dual-plane and subpectoral placement according to each patient&#8217;s anatomy, tissue coverage, implant and goals. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39989707\/\" rel=\"noopener\" target=\"_blank\">Read the systematic review and meta-analysis<\/a>.<\/p>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>Implant surface<\/h3>\n<p>\u201cTextured\u201d does not describe a single type of surface. Historically used macrotextured implants, lower-roughness microtextured surfaces such as MESMO, and smooth or minimally rough surfaces such as SmoothSilk have different clinical profiles. Rougher surfaces were historically associated with less contracture in some settings, but also with late seromas and other surface-specific complications.<\/p>\n<p>In our published series of 621 procedures, contracture rates were comparable between POLYtxt and MESMO. The more striking difference was late seroma\u20146.4% with POLYtxt versus 0% with MESMO\u2014alongside lower overall complication and reoperation rates with MESMO. Each surface needs to be assessed separately; the same risk cannot automatically be attributed to every textured implant. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33582050\/\" rel=\"noopener\" target=\"_blank\">Read the study by Marcelli and Aso<\/a>.<\/p>\n<\/section><\/div>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"reducir-riesgo\">\n<h2>Can capsular contracture be prevented?<\/h2>\n<p>Complete prevention cannot be guaranteed. We can, however, <strong>reduce the risk<\/strong> through appropriate patient selection, precise pocket dissection, meticulous control of bleeding, infection-prevention measures, careful handling of the implant and postoperative follow-up.<\/p>\n<p>In the operating room, we use a meticulous technique: careful hemostasis, minimal handling of tissues and the implant, glove changes and <em>no-touch<\/em>-type measures. Antibiotic prophylaxis is tailored to the procedure and clinical protocol. Insertion devices\u2014such as the Keller Funnel or the mia Femtech injector\u2014allow more controlled insertion with less contact, but should not be presented as a proven guarantee against contracture.<\/p>\n<p>The incision may also play a role. A meta-analysis found an association between periareolar incisions and more contracture than inframammary incisions, although the evidence comes from comparative studies of limited quality. This does not mean a periareolar approach is wrong in every case. The incision should be chosen in the context of all relevant factors. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28916908\/\" rel=\"noopener\" target=\"_blank\">Read the meta-analysis<\/a>.<\/p>\n<p>Implant placement and implant type should be individualized. No single surface, incision or technique is always best for every patient.<\/p>\n<aside class=\"aso-contracture__note\">\n<h3>Massage, therapeutic ultrasound and montelukast<\/h3>\n<p>Our protocol does not recommend routine breast massage to prevent contracture. Nor do we present therapeutic ultrasound or medication as universal solutions: any treatment plan should be individualized and should never replace an examination when a breast becomes firmer or changes shape.<\/p>\n<p><strong>Montelukast<\/strong> has been studied off-label as a possible preventive or adjunctive treatment. A <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41507494\/\" rel=\"noopener\" target=\"_blank\">systematic review published in 2026<\/a> describes promising findings mainly in early cases, but limited effects in Baker III\u2013IV contracture and evidence that remains low quality. It does not replace surgery when surgery is indicated. Prescribing decisions must weigh individual benefits and risks, including the <a href=\"https:\/\/www.fda.gov\/drugs\/drug-safety-communications\/la-fda-exige-un-recuadro-de-advertencia-acerca-de-los-efectos-secundarios-graves-para-la-salud\" rel=\"noopener\" target=\"_blank\">warning about possible neuropsychiatric effects<\/a>.<\/p>\n<\/aside>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"diagnostico-contractura\">\n<h2>How is capsular contracture diagnosed?<\/h2>\n<p>Diagnosis begins with your medical history and an examination of both breasts. We assess how symptoms have evolved, breast firmness, pain, shape, implant position and changes since previous appointments.<\/p>\n<div class=\"aso-contracture__diagnosis-grid\">\n<section class=\"aso-contracture__card\">\n<h3>Clinical examination<\/h3>\n<p>This allows us to estimate the Baker grade and assess whether firmness is accompanied by distortion, upward displacement of the implant or pain.<\/p>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>Ultrasound<\/h3>\n<p>Ultrasound assesses the implant and surrounding tissues, detects even small fluid collections and helps distinguish contracture from seroma, rupture and other changes.<\/p>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>MRI<\/h3>\n<p>MRI may be appropriate if a silicone implant rupture is suspected or ultrasound cannot resolve an important question.<\/p>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>Investigation of a late seroma<\/h3>\n<p>If a <a href=\"https:\/\/www.doctoraso.es\/blog\/seroma-o-liquido-despues-de-un-aumento-de-pecho-con-protesis-que-es-y-como-solucionarlo\/\">late seroma<\/a> develops, ultrasound-guided aspiration and cytology with immunohistochemistry, including appropriate markers such as CD30 and ALK, are essential. It should not simply be treated as contracture without completing this investigation.<\/p>\n<\/section><\/div>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"tratamiento-contractura\">\n<h2>Treatment of capsular contracture<\/h2>\n<p>Treatment depends on the grade, symptoms, how long the problem has been present, implant condition, surface, placement and medical history. A mild, stable contracture is not managed in the same way as a painful, visibly distorted breast.<\/p>\n<div class=\"aso-contracture__treatment-grid\">\n<section class=\"aso-contracture__card aso-contracture__card--normal\">\n<h3>Baker I<\/h3>\n<p>The breast is soft and normal. No treatment of the capsule is needed.<\/p>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>Baker II<\/h3>\n<p>If the breast looks normal, is painless and remains stable, it may be monitored with clinical reviews and ultrasound.<\/p>\n<\/section>\n<section class=\"aso-contracture__card aso-contracture__card--contracture\">\n<h3>Baker III\u2013IV<\/h3>\n<p>When there is significant distortion, pain or progression, revision surgery is often considered. The decision is tailored to the individual case.<\/p>\n<\/section>\n<section class=\"aso-contracture__card\">\n<h3>Recurrent contracture<\/h3>\n<p>We need to review possible causes, implant placement, the previous implant, tissue quality and options to reduce the risk of another recurrence.<\/p>\n<\/section><\/div>\n<p>Surgery may combine implant removal or exchange, capsulotomy, partial or total capsulectomy, correction of the implant pocket and a change of implant placement. The available evidence does not support one mandatory combination for every patient. In our practice, advanced contracture generally means removing the implant associated with the problem and carefully planning how to address the capsule, without reusing the explanted device.<\/p>\n<p>When contracture is accompanied by thin tissues, breast drooping or significant distortion, secondary surgery may also include <strong>fat grafting, a breast lift or a flap of the patient&#8217;s own tissue<\/strong> to improve coverage and restore breast shape. These are useful reconstructive techniques, but they do not replace treatment of the capsule or guarantee that contracture will not recur.<\/p>\n<aside class=\"aso-contracture__protocol\">\n<h2>What does \u201cen bloc capsulectomy\u201d mean?<\/h2>\n<p>Surgeons use <strong>\u201cen bloc capsulectomy\u201d<\/strong> to describe removal of the capsule and implant together, in one piece, without opening the capsule. If fluid has collected around the implant, the aim is to keep it contained within the specimen.<\/p>\n<p>This approach is particularly relevant when there is a late seroma, suspected capsular disease or a need to preserve the specimen intact for analysis, provided it can be performed safely. The term should not be used as a synonym for every total capsulectomy: the indication depends on the findings and on how the capsule relates to the chest wall.<\/p>\n<p><strong>A note on terminology:<\/strong> we retain \u201cen bloc capsulectomy\u201d here because surgeons and patients commonly use it for this intact, combined removal. Some recent international consensus statements call the same procedure \u201ctotal intact capsulectomy\u201d when no margin of healthy tissue is included, reserving \u201cen bloc\u201d in the oncological sense for removal with a margin. What matters most is accurately describing what is removed and how.<\/p>\n<\/aside>\n<p>If a new implant is placed, it should be chosen for the patient&#8217;s current circumstances. For patients with macrotextured implants, late seromas or surface-related problems, we generally consider much smoother implants\u2014smooth, nanotextured or microtextured\u2014while assessing the individual risks of contracture, malposition and other complications.<\/p>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"protocolo-contractura\">\n<div class=\"aso-contracture__protocol\">\n<h2>Our approach at Cl\u00ednica Dr. Aso<\/h2>\n<p>The aim is not to label a firm breast as contracture too quickly. It is to confirm the diagnosis, rule out associated problems and choose the least invasive option that is both safe and predictable.<\/p>\n<div class=\"aso-contracture__protocol-grid\">\n<div class=\"aso-contracture__protocol-item\">\n        <strong>Routine follow-up ultrasound<\/strong><br \/>\n        <span>We perform follow-up ultrasound after breast surgery involving implants. It helps document changes over time, assess the device and detect even very small fluid collections.<\/span>\n      <\/div>\n<div class=\"aso-contracture__protocol-item\">\n        <strong>Clinical and ultrasound comparison<\/strong><br \/>\n        <span>Before assigning a grade, we assess both breasts, their firmness, shape and position, any pain, and changes since previous appointments.<\/span>\n      <\/div>\n<div class=\"aso-contracture__protocol-item\">\n        <strong>Late seroma: specific investigation<\/strong><br \/>\n        <span>If fluid appears years later, we arrange ultrasound-guided aspiration and cytology with immunohistochemistry through a specialist partner laboratory.<\/span>\n      <\/div>\n<div class=\"aso-contracture__protocol-item\">\n        <strong>Surgery planned for the individual case<\/strong><br \/>\n        <span>If surgery is needed, we decide how much capsule to remove and how to manage the pocket, implant placement and new device according to the findings and medical history.<\/span>\n      <\/div><\/div><\/div>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"fotos-contractura\">\n<h2>What can capsular contracture look like? Photos of a real case<\/h2>\n<p class=\"aso-contracture__section-intro\">Its appearance varies considerably. Some patients primarily notice firmness; others develop a higher breast position, a rounder shape or visible distortion. The following images show a patient treated with a <a href=\"https:\/\/www.doctoraso.es\/en\/mastopexy-in-madrid\/\">breast lift<\/a> and <a href=\"https:\/\/www.doctoraso.es\/en\/breast-implant-revision-in-madrid\/\">replacement of ruptured implants<\/a> affected by contracture.<\/p>\n<div class=\"aso-contracture__case\">\n<div class=\"aso-contracture__case-images\">\n<figure>\n        <picture><source type=\"image\/webp\" srcset=\"https:\/\/www.doctoraso.es\/wp-content\/uploads\/2026\/07\/contractura-capsular-caso-real-frontal.webp\"><img src=\"https:\/\/www.doctoraso.es\/wp-content\/uploads\/2020\/02\/465_AP-768x480.jpg\" width=\"768\" height=\"480\" loading=\"lazy\" decoding=\"async\" fetchpriority=\"low\" alt=\"Front before-and-after view of a breast lift and replacement of ruptured implants affected by contracture\">\n        <\/picture><figcaption>Front view: before surgery and after a breast lift and replacement of the ruptured implants affected by contracture.<\/figcaption><\/figure>\n<figure>\n        <picture><source type=\"image\/webp\" srcset=\"https:\/\/www.doctoraso.es\/wp-content\/uploads\/2026\/07\/contractura-capsular-caso-real-lateral.webp\"><img src=\"https:\/\/www.doctoraso.es\/wp-content\/uploads\/2020\/02\/465_LAT-768x480.jpg\" width=\"768\" height=\"480\" loading=\"lazy\" decoding=\"async\" fetchpriority=\"low\" alt=\"Side before-and-after view of a breast lift and replacement of implants affected by contracture\">\n        <\/picture><figcaption>Side view of the same case: an individual result after correcting the contracture and replacing the implants.<\/figcaption><\/figure>\n<\/p><\/div>\n<p class=\"aso-contracture__case-copy\"><strong>Individual result:<\/strong> these photographs show one patient&#8217;s outcome and cannot, on their own, establish the grade of contracture. The appropriate treatment and result depend on each patient&#8217;s anatomy, implant, capsule and surgical needs. You can also explore our <a href=\"https:\/\/www.doctoraso.es\/fotos-antes-y-despues-aumento-pecho\/\">gallery of real breast surgery cases<\/a>.<\/p>\n<\/p><\/div>\n<\/section>\n<section class=\"aso-contracture__section\" id=\"preguntas-contractura\">\n<h2>Frequently asked questions about capsular contracture<\/h2>\n<div class=\"aso-contracture__faq\">\n<details>\n<summary>How can I tell whether I have capsular contracture?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>The most characteristic sign is progressive firmness. In advanced cases, the breast may also sit higher, look rounder or distorted, or become painful. An examination is needed to confirm the cause; ultrasound helps rule out other problems.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>Why does one implant feel harder than the other?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>Contracture is one possibility, but a difference can also reflect pre-existing asymmetry, different tissue coverage, muscle tension, malposition, seroma or rupture. A new or increasing difference should be assessed.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>I have pain after ten years with implants. Is it contracture?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>Not necessarily. Pain years after surgery can arise from the breast, muscles or implant. An examination and ultrasound can assess the capsule, implant integrity and any fluid collection.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>Can capsular contracture go away without surgery?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>Mild Baker grade II firmness may remain stable and be monitored. With established Baker grade III or IV contracture, particularly when there is distortion or pain, non-surgical treatments have unpredictable results and surgery is often considered.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>Does montelukast treat capsular contracture?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>It has been studied off-label and may have a preventive or supporting role in some early cases, but the evidence remains limited. Its effect is generally insufficient for Baker grade III\u2013IV contracture, and it does not replace surgery when surgery is indicated. It should be prescribed on an individual basis, with an explanation of possible adverse effects.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>Should I massage a breast with capsular contracture?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>We do not recommend starting massage on your own or presenting it as a universal way to prevent or treat contracture. Advice depends on the implant, technique, time since surgery and examination findings.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>Does the implant always need to be replaced?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>In surgery for advanced contracture, we generally remove the implant associated with the problem. If the patient wants to retain implant volume, a new implant may be placed. The full strategy\u2014for the capsule, pocket, implant placement and device\u2014is individualized.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>Can capsular contracture return after surgery?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>Yes. Surgery treats the existing problem but cannot eliminate the possibility of recurrence. That is why we assess factors that may have contributed to the first episode and maintain follow-up.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>Is capsular contracture dangerous?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>Contracture itself is usually a local complication, not cancer. However, late swelling, fluid around the implant, a lump or inflammation should not automatically be attributed to contracture because other conditions need to be ruled out.<\/p>\n<\/div>\n<\/details>\n<details>\n<summary>What tests are needed?<\/summary>\n<div class=\"aso-contracture__faq-answer\">\n<p>Clinical examination is the starting point. At our clinic, we also use follow-up ultrasound. We use MRI if an important question remains about silicone implant integrity, and ultrasound-guided aspiration with cytology and immunohistochemistry when a late seroma occurs.<\/p>\n<\/div>\n<\/details><\/div>\n<\/section>\n<aside class=\"aso-contracture__related\">\n  <strong>Related information<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.doctoraso.es\/en\/breast-augmentation-in-madrid\/\">Breast augmentation: techniques, implants and planning<\/a><\/li>\n<li><a href=\"https:\/\/www.doctoraso.es\/en\/breast-implant-revision-in-madrid\/\">Breast implant replacement<\/a><\/li>\n<li><a href=\"https:\/\/www.doctoraso.es\/blog\/seroma-o-liquido-despues-de-un-aumento-de-pecho-con-protesis-que-es-y-como-solucionarlo\/\">Seroma around a breast implant<\/a><\/li>\n<li><a href=\"https:\/\/www.doctoraso.es\/en\/mastopexy-in-madrid\/\">Breast lift: indications and planning<\/a><\/li>\n<li><a href=\"https:\/\/www.doctoraso.es\/fotos-antes-y-despues-aumento-pecho\/\">Real breast augmentation cases<\/a><\/li>\n<li><a href=\"https:\/\/www.doctoraso.es\/en\/blog\/breast-augmentation-aftercare\/\">Recovery after breast augmentation<\/a><\/li>\n<\/ul>\n<\/aside>\n<\/article>\n<p><br \/>\n[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row css=&#8221;.vc_custom_1751024304581{margin-top: 15px !important;}&#8221; css_params=&#8221;&#8221;][vc_column][vc_column_text css=&#8221;&#8221; css_params=&#8221;&#8221;] A medical guide to breast implants Capsular contracture develops when the capsule of scar tissue that normally forms around a breast implant becomes thicker and tightens more than expected. It can make the breast feel firm or change its shape and, in more advanced cases, cause pain. Not [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":23600,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_joinchat":[],"footnotes":""},"categories":[78,80],"tags":[],"class_list":["post-23594","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-breast-augmentation","category-cosmetic-surgery"],"acf":[],"featured_image_src":{"landsacpe":["https:\/\/www.doctoraso.es\/wp-content\/uploads\/2025\/07\/contractura-capsular-1140x445.jpg",1140,445,true],"list":["https:\/\/www.doctoraso.es\/wp-content\/uploads\/2025\/07\/contractura-capsular-463x348.jpg",463,348,true],"medium":["https:\/\/www.doctoraso.es\/wp-content\/uploads\/2025\/07\/contractura-capsular-300x204.jpg",300,204,true],"full":["https:\/\/www.doctoraso.es\/wp-content\/uploads\/2025\/07\/contractura-capsular.jpg",2048,1392,false]},"yoast_head":"<!-- This site is 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Lidera la cl\u00ednica Dr. Aso, l\u00edder a nivel nacional en cirug\u00eda mamaria, adem\u00e1s de otros procedimientos de cirug\u00eda est\u00e9tica. Licenciado en Medicina y Cirug\u00eda por la Universidad de Zaragoza, se gradu\u00f3 con menci\u00f3n especial y 14 Matr\u00edculas de Honor. Su especializaci\u00f3n en Cirug\u00eda Pl\u00e1stica, Est\u00e9tica y Reparadora la complet\u00f3 a trav\u00e9s del sistema MIR en el Hospital Universitario Doce de Octubre (Madrid), uno de los m\u00e1s prestigiosos en Espa\u00f1a. Es Doctor en Medicina \u201cCum Laude\u201d por la Universidad Complutense de Madrid, gracias a su Tesis Doctoral de estudio morfom\u00e9trico facial. Es miembro numerario de la SECPRE (Sociedad Espa\u00f1ola de Cirug\u00eda Pl\u00e1stica, Reparadora y Est\u00e9tica) y del Ilustre Colegio de M\u00e9dicos de Madrid. El Dr. Aso imparte docencia a especialistas en Cirug\u00eda pl\u00e1stica de toda Espa\u00f1a y participa frecuentemente en los congresos m\u00e1s importantes de la especialidad como profesor invitado. Ha sido reconocido como el mejor cirujano pl\u00e1stico en Madrid en diversos premios y menciones, entre ellos por el portal Doctoralia, y gan\u00f3 el Premio al mejor Cirujano Pl\u00e1stico de Espa\u00f1a en 2015. Su experiencia en cirug\u00eda reconstructiva es muy amplia, habiendo trabajado en el Hospital Universitario del Ni\u00f1o Jes\u00fas y en el Hospital Universitario Doce de Octubre como facultativo especialista. Ha trabajado en estos hospitales p\u00fablicos durante m\u00e1s de 15 a\u00f1os. Tambi\u00e9n es todo un referente en la ense\u00f1anza, habiendo sido colaborador docente en la Universidad Complutense de Madrid durante m\u00e1s de 10 a\u00f1os y Director de Departamento en la Academia AMIR. Su carrera est\u00e1 respaldada por publicaciones cient\u00edficas y conferencias a nivel internacional. 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