When any foreign body (such as a breast implant) is placed within the human body, an inflammatory reaction occurs as the body attempts to form a protective barrier around the foreign object to separate it from surrounding tissue. This protective barrier (or “capsule”) consists of the formation of scar tissue that surrounds the foreign object.  As this scar tissue forms and builds up over time, it can eventually result in a thickening of the capsule wall.  In the case of breast implants, this thickening can lead to a tightening or stiffening of the breast implant which can cause the breast implants to become firm to touch and visibly deformed.  This process, or capsular contracture, is the most common long-term complication of breast implant surgery.  Capsular contracture around breast implants can occur in 10 to 20% of cases over the first 10 years of surgery.

The standard of care for treating capsular contracture is capsulectomy or surgical removal of all or most of the capsule.  There are two types of capsulectomy surgery: total and sub-total.  In a total capsulectomy, the entire capsule is removed and the breast implant is replaced.  A sub-total capsulectomy involves partial removal of the capsule and can be performed if the breast implant has not ruptured or shifted from its original placement within the body.  Even with a sub-total capsulectomy, the breast implant is usually replaced.  The theory behind implant replacement in both approaches is the belief that the body will form a more favorable capsule and that the new breast implant(s) will therefore last longer.  Capsulectomy surgery takes around 1.5 – 3 hours to perform, is usually done under general anesthesia, and generally requires an overnight stay in the hospital.