When a foreign object such as breast implants, a pacemaker, or an artificial joint is inserted into the body, it will form a protective scar capsule around the object. It is a natural healing response and is expected.
Baker Scale Grades Firmness of the Breast
For some breast augmentation patients, during the first year of healing, the capsule that forms around the breast implant may shrink (contract). The web of fibrous material making up the capsule tightens and squeezes the implant, making it feel hard. There are varying degrees of encapsulation. Dr. James Baker created the “Baker Scale of Capsular Contracture,” which is used worldwide to grade the degree of firmness of an augmented breast.
• Baker Grade l The breast feels soft and appears normal
• Baker Grade ll The breast feels slightly firm but appears normal
• Baker Grade lll The breast feels firm and appears abnormal
• Baker Grade lV The breast feels hard, appears abnormal and is painful
Capsular Contracture Affects Only a Few
Dr. Miguel Delgado, M.D. states that capsular contracture can develop at any time, but is more prevalent in the first few months after breast augmentation surgery. Fortunately, only a small percentage of women develop a problematic contracture.
According to a publication in the US National Library of Medicine at the National Institute of Health, capsular contracture usually is a result of subclinical colonization of bacteria within the implant pocket.
New Techniques to Combat Capsular Contracture
With all the latest techniques to minimize the chances of capsular contracture, the contracture can still occur. However, the rate has been greatly reduced in recent years thanks to techniques such as placement of the implant under the muscle, the Keller funnel (a device that allows the surgeon to insert the implant without touching it), and antibiotics.