Understanding Capsular Contracture: Mechanisms, Management, and Patient Outcomes
A review of capsular contracture — the abnormal thickening and hardening of the scar-tissue capsule around an implant — covering how it is graded, the leading proposed mechanisms, and risk factors.
View original source ↗What this source says
The review describes capsular contracture as an exaggerated fibrotic response in which the capsule hardens and can distort the breast or cause pain; it is commonly graded with the Baker scale (I–IV); leading proposed mechanisms include chronic inflammation and bacterial biofilm; and risk factors include radiation, implant surface, pocket location, and smoking.
Why it matters
A current synthesis of the most common long-term implant complication — helpful for understanding what “contracture” and “Baker grade” mean.
Key findings
- Reported to affect roughly 5–19% of augmentation and 19–25% of reconstruction patients.
- Graded with the Baker scale (I–IV), which the authors call subjective and practitioner-dependent.
- Leading proposed mechanisms: chronic inflammation, bacterial biofilm, and fibroblast activation.
- Risk factors include post-mastectomy radiation, implant surface texture, pocket location, and smoking.
Limitations
The authors note most evidence comes from retrospective cohort studies without randomized trials (a moderate-to-high risk of bias), and that Baker grading is subjective.
What this does not prove
It describes associations and proposed mechanisms; it does not establish a single proven cause of capsular contracture.
Source / citation
Clark et al. · Plastic and Reconstructive Surgery — Global Open · 2026
https://pmc.ncbi.nlm.nih.gov/articles/PMC12803722/
- DOI:
- 10.1097/GOX.0000000000007407
Last reviewed against the original source: 2026-09-02. Summaries are written in plain language; the original source is authoritative.
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