Every implant forms a thin scar capsule around it — that is normal. When the capsule thickens and tightens, the breast can feel firm or hard, look rounder or sit higher, and sometimes ache. This is capsular contracture. Dr Thomas Colson assesses and treats it at SKMC in Abu Dhabi, restoring a soft, natural breast through implant revision.
After any breast implant, the body forms a thin layer of scar tissue — the capsule — around it. In most patients this capsule stays soft and is never noticed. In capsular contracture the capsule becomes thicker and contracts, squeezing the implant so the breast feels firm or hard, may look rounder or ride higher, and can become tender or painful.
Surgeons grade severity on the Baker scale, which guides whether the breast is simply watched or whether revision is advised.
No. Capsular contracture is not dangerous in itself and there is usually no need to act overnight. A new firmness, change in shape or persistent pain should, however, be assessed — both to confirm the diagnosis and to exclude other causes such as a fluid collection or implant rupture.
| Baker grade | How the breast feels & looks | Usual approach |
|---|---|---|
| I | Soft, looks and feels natural | Normal — no treatment |
| II | A little firm, looks normal | Monitored |
| III | Firm and visibly distorted | Revision usually advised |
| IV | Hard, distorted and painful | Revision advised |
The exact cause is not always known. Recognized contributors include a low-grade bacterial film (biofilm) on the implant, bleeding or haematoma after surgery, and factors related to the implant surface and pocket. It can appear months or years after the original operation.
At SKMC, Dr Colson uses measures shown to reduce contracture risk: a Keller Funnel no-touch insertion that limits implant contact, careful control of bleeding, pocket irrigation, and an appropriate implant and plane. No technique removes the risk entirely.
Dr Colson confirms capsular contracture by examination and, where needed, imaging such as ultrasound or MRI to grade the capsule and check the implant. A Crisalix 3D simulation can be used when planning the corrected shape.
Mild, early firmness (Baker I–II) is usually monitored. Established contracture that causes hardness, distortion or pain (Baker III–IV) is treated surgically, because the thickened capsule itself must be addressed.
Treatment is planned as a breast implant revision: removal of the thickened capsule (capsulectomy), exchange of the implant — often moving it to a prepectoral plane — and adjunct measures to lower the chance of recurrence. The exact plan depends on your anatomy and the grade of contracture.
In line with UAE Department of Health guidelines on modesty and medical advertising, breast surgical results are not published online. Outcomes relevant to your own anatomy are reviewed privately during your consultation, alongside a Crisalix 3D simulation of your planned result.
Consultations and surgery with Dr Thomas Colson are performed exclusively at Sheikh Khalifa Medical City (SKMC) in Abu Dhabi, within the SEHA network. If a breast has become firm, changed shape or is uncomfortable, it can be examined and, where needed, imaged to plan treatment.