Health and Fitness

Do I need surgery if breast implant hardens or is elevated?


Breast implants can become hardened and elevated or depressed, which is caused by a capsular contraction. Surgery may be needed to replace the implant.


Q. I had breast implants approximately one year ago and lately I’ve noticed that one of them seems harder and more elevated than the other. Why is this and what can be done about it?

A. What you are describing is a capsular contraction. This is when the fibrous tissue surrounding the implant starts contracting and thickens. When a patient has a capsular contraction, there may be some pain and discomfort. Patients may also notice a depression of the implant along with some range-of-motion issues.

Capsular contraction can come from previous radiation, genetic predisposition or a hematoma (blood accumulation around implant).

Patients with capsular contraction may be asked to do gentle or firm massaging depending on what your plastic surgeon recommends. If this does not work, you may need surgery to correct this problem.

Surgery consists of a complete capsulectomy, that is, removing the scar tissue that forms around the implant. Often, a new implant will be placed.

There are implants that may be less prone to capsule formations. All these questions must be asked prior to having your surgery when you speak to your plastic surgeon.

Some surgeons may recommend a partial capsulectomy, where the entire capsule is not removed but portions of it are removed. In addition, your surgeon may recommend that the implant be wrapped in a cellular matrix that helps prevent a new capsular contraction. If you have had several capsular contractions, your doctor may recommend that you no longer have breast implants.

While capsule contractions do occur, they are not generally problematic and most patients have a great experience with breast implants. Like any other surgery, breast surgery has risks and complications. Capsule contraction is one of these complications that may occur and you should talk to your plastic surgeon prior to having any breast surgery.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at

Dr. Carlos Wolf

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