Condition
Capsular contracture
A breast with an implant has become firmer, changed shape, and perhaps hurts — on one side or both. This may be capsular contracture: the capsule that the body forms around every implant has tightened. It is not life-threatening, but it does not get better on its own.
Why does it happen?
Around every implant the body forms a thin layer of connective tissue (a capsule) — this is a normal response to a foreign body. In some women this capsule thickens and tightens, and squeezes the implant: the breast becomes hard, moves upwards, takes on a "ball-like" shape, and sometimes hurts. It can appear in the first year after surgery, but also many years later.
Why it happens to some and not to others is not fully known. Today the most important cause is thought to be a thin layer of bacteria on the surface of the implant (a biofilm) that keeps up a mild, long-lasting inflammation. The risk is increased by blood or fluid collecting around the implant after surgery, placing the implant under the gland instead of under the muscle, the rough-textured shells of older generations of implants, smoking and a tendency to form scars. You could not have prevented any of this yourself — and it does not mean the operation was done badly.
What most often brings people to an examination?
The breast feels firmer to the touch than before, "sits" higher than the other or has lost its natural droop; pain or a feeling of tightness, especially when lying on your front; a clearly visible edge of the implant; a difference between the two sides that grows over time. A milder grade — the breast is slightly firmer, but its look and feel are normal — does not need surgery, only monitoring. Surgery is done when the firmness, shape or pain bother you.
The examination includes an ultrasound and, when needed, an MRI scan. What is checked with it and how implants are monitored → Breast implants
What can be done?
Surgery removes the tightened capsule (capsulectomy). What is done next depends on three things — where the implant is placed, how old it is and what has happened to the breast in the meantime:
| Problem | Procedure | Also, in the same visit |
|---|---|---|
| The breast is hard, moved upwards or hurts; the implant stays or is replaced | Breast implant replacement (re-augmentation) | Removing the capsule, replacing the implant and lifting the breasts are done in one procedure, because they result from the same condition. |
| You no longer want the implants | Breast implant removal (explantation) | A lift or filling with your own fat, in the same procedure. |
Warranty. When contracture is covered by the manufacturer's warranty and what applies to an implant without documentation → Breast implants
Specialist and team
Specialty: plastic, reconstructive and aesthetic surgery.
When the procedure is done under sedation or general anaesthesia, the anaesthesia is led by a specialist in anaesthesiology, resuscitation and intensive care who works full time at the clinic.
In the operating theatre, the surgeon is assisted by head nurse Martina Šereg, with the help of nurses Kristina Jurešić and Mateja Tomorad, and in recovery the care assistant Mirjana Kovačić is with you. Martina also looks after preparation, scheduling and contact after the procedure.
Who will operate is decided at the examination, based on the findings and the type of procedure. You know the name of the surgeon before the procedure and meet them at the examination.
→ Doctors and team at Poliklinika Barbel
We also see patients who were operated on elsewhere — bring the documentation about your implants if you have it.
Frequently asked questions
Is capsular contracture dangerous? It is not life-threatening. It can be painful and can deform the breast, and when it occurs together with a ruptured implant, it needs surgery. It does not increase the risk of breast cancer. An extremely rare malignant disease of the capsule with rough-textured implants → Breast implants
Does it have to be operated on straight away? No. A milder grade is monitored. Surgery is done when the firmness, shape or pain bother you, or when the implant is damaged along with the contracture.
Can it be solved without surgery? A tightened capsule does not loosen with massage or medicines. Treatments that slow its progress exist and are discussed at the examination, but a tightened capsule is removed only by surgery.
Does contracture interfere with breastfeeding? No. The capsule is around the implant, not in the gland.
Medical review: doctors of Poliklinika Barbel · October 2026.