Fortunately, serious breast augmentation surgery complications are very rare. There are some less serious complications that may occur and at some point, may require corrective plastic surgery. Capsular contracture is one of these plastic surgery breast implant complications that may require a second plastic surgery.

The breast implant during breast augmentation surgery is placed above or below the muscle and within about a two week time frame, a thin layer of scar tissue forms along the pocket that was created to place the breast implant under the breast. This layer of scar tissue is about the thickness of a thin grape skin. Some plastic surgeons place the breast implant and only create a small pocket, just large enough for the breast implant to be positioned. In this case the implant scar tissue pocket or 'capsule' is close to the breast implant. Other plastic surgeons place the breast implant after they have created a large and generous pocket for the implant to be positioned in. If the implant is moved during this early healing stage, the scar tissue capsule forms away from the breast implant. So a larger pocket forms and this usually allows for the breast implant to not be constrained or contracted by the scar tissue.

Over a period of time, in some breast augmentation patients, the scar tissue capsule will become thicker and tighten around the breast implant. This scar tissue layer can become the thickness of an orange peel. This tightening is called 'contracture' and when this occurs it is called a capsular contracture. A breast capsular contracture may be mild or very severe. It can lead to mild to marked distortion of the breast shape and even cause pain in its later stages. Capsular contracture can occur using either silicone or saline filled breast implants.

In mild cases, the scar tissue capsule may be partly removed and the remainder cut to release any tightness. When the scar is released a new wider layer is formed and the capsule is larger.

In severe cases, a secondary plastic surgery is required to completely remove the capsule scar tissue. It is more common to see this type of capsular contracture in older silicone gel implants placed above the muscle.

It is more common to see capsular contracture in breast augmentations placed above the muscle. Capsular contracture may be caused by blood that was left or collected around the implant after the breast augmentation surgery. Capsular contracture may also be caused by a low grade infection that has been contained in the scar tissue pocket. Sometimes this occurs because the woman's body has continued to place scar tissue around the implant. Capsular contracture is not a 'rejection' of the breast implant. It is a complication or consequence that may occur after breast augmentation surgery.