How We Approach Capsular Contracture Correction
Capsular contracture is a tissue response, not a placement error.. The capsule, once thickened, will not relax on its own. Modern surgical correction usually involves partial or removal of the entire capsule, followed by a decision about whether to place a new implant and how to reinforce the pocket.
Two factors meaningfully change recurrence risk:
First, implant plane. Where the implant sits relative to the muscle and fascia influences contracture risk, though the relationship is not uniform across patients or implant types. Submuscular placement has the longest outcomes data supporting lower contracture rates, as reflected in a systematic review of submuscular implant placement and a separate study in Plastic and Reconstructive Surgery. Subfascial placement has gained meaningful ground in recent years, with emerging literature reporting comparably low contracture rates in selected patients. Dr. Lickstein evaluates plane selection individually based on each patient’s anatomy, implant history, and prior result.
Second, tissue support with acellular dermal matrix or mesh.A 2025 series in Plastic and Reconstructive Surgery reported a 90 percent success rate in surgical treatment of Baker III and IV capsular contracture when acellular dermal matrix was added to capsulectomy. The long-term multicenter BROWSE study found lower revision rates for contracture and higher patient-reported satisfaction in matrix-supported reconstructions over a median nine-year follow-up. Additional analysis ofbiologic and synthetic mesh in revision reconstructionconfirms that scaffold materials help prevent recurrent contracture.
These decisions, plane, capsulectomy strategy, and reinforcement, are made case by case. Dr. Lickstein has spent more than two decades performing both primary and revision breast surgery, including complex reconstructive cases, and that depth drives the surgical plan.
Capsular contracture is a tissue response, not a placement error.. The capsule, once thickened, will not relax on its own. Modern surgical correction usually involves partial or removal of the entire capsule, followed by a decision about whether to place a new implant and how to reinforce the pocket.
Two factors meaningfully change recurrence risk:
First, implant plane. Where the implant sits relative to the muscle and fascia influences contracture risk, though the relationship is not uniform across patients or implant types. Submuscular placement has the longest outcomes data supporting lower contracture rates, as reflected in a systematic review of submuscular implant placement and a separate study in Plastic and Reconstructive Surgery. Subfascial placement has gained meaningful ground in recent years, with emerging literature reporting comparably low contracture rates in selected patients. Dr. Lickstein evaluates plane selection individually based on each patient’s anatomy, implant history, and prior result.
Second, tissue support with acellular dermal matrix or mesh.A 2025 series in Plastic and Reconstructive Surgery reported a 90 percent success rate in surgical treatment of Baker III and IV capsular contracture when acellular dermal matrix was added to capsulectomy. The long-term multicenter BROWSE study found lower revision rates for contracture and higher patient-reported satisfaction in matrix-supported reconstructions over a median nine-year follow-up. Additional analysis ofbiologic and synthetic mesh in revision reconstructionconfirms that scaffold materials help prevent recurrent contracture.
These decisions, plane, capsulectomy strategy, and reinforcement, are made case by case. Dr. Lickstein has spent more than two decades performing both primary and revision breast surgery, including complex reconstructive cases, and that depth drives the surgical plan.
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