Breast Implant Exchange because of Capsular Contracture: When Your Body Sends a Signal.

When a breast implant is placed, the body responds naturally: it forms a thin layer of connective tissue around the implant – called the capsule. This is a normal and healthy healing process. In some women, however, this capsule gradually thickens and hardens, beginning to compress the implant. This is what we refer to as capsular contracture or capsule fibrosis.

The exact causes are not yet fully understood, but the following factors are known to increase the risk: microorganisms on the implant surface (subclinical infection), older or smooth implants, implants positioned above the muscle, haematomas or seromas following the original surgery, and a genetic predisposition to excessive scar tissue formation.

Typical Symptoms of Capsular Contracture

• Increasing firmness of the breast: The implant feels harder than it did immediately after surgery – sometimes rock-solid.
• Changed breast shape: The breast appears rounder, more spherical, or rides higher on the chest. The natural teardrop shape is lost.
• Visible distortion: The implant may appear displaced, or noticeable asymmetry develops.
• Tightness or pain: Particularly in more advanced cases, patients experience pressure, pulling sensations, or chronic discomfort.
• Psychological impact: Altered body confidence, withdrawal from intimate situations, uncertainty.

The Baker Classification – Grades of Capsular Contracture

In plastic surgery, capsular contracture is classified using the Baker scale, divided into four grades:

From Grade III onwards, we at Dr. Kelly® generally recommend surgical treatment – the most thorough and lasting solution for achieving a soft, symmetrical, and natural long-term result.

Capsular contracture is diagnosed primarily through clinical assessment – a hands-on examination combined with a thorough consultation with your surgeon. In certain cases, we complement the assessment with imaging such as ultrasound or MRI to evaluate the condition of the implant and capsule in greater detail.

For early-stage capsular contracture (Baker Grade II), we recommend close monitoring, as timely intervention in selected cases may be beneficial before the hardening progresses further. From Baker Grade III–IV, there is generally a clear indication for surgery – particularly where visible changes in shape, firmness, or discomfort are present. In these cases, surgical implant exchange with capsule removal is typically the most effective and lasting treatment.

Conservative Management Options (Grade I–II)

• Regular medical review: Close monitoring of consistency and breast shape.
• Massage and mobilisation: May have a supportive effect in early stages.
• Anti-inflammatory approaches: In selected cases, medically supervised anti-inflammatory therapy may be considered.

Surgical Solution (Grade III–IV) – Our Recommendation

For advanced capsular contracture, surgery is the only truly effective treatment. It offers the opportunity to address the cause completely, renew the implants, and improve the aesthetic result at the same time. In our clinic, every case is evaluated individually – with the goal of choosing the most gentle and lasting approach for you.

The procedure combines two goals in one: the complete removal or treatment of the fibrous capsule, and the placement of new, modern implants. At Dr. Kelly®, we always select the approach individually based on your specific findings.

Total Capsulectomy

For advanced capsular contracture (Grade III–IV), we generally recommend complete removal of the capsule. The hardened connective tissue is removed en bloc together with the implant. This minimises the risk of recurrence and creates optimal conditions for the new implant.

Capsulotomy

In milder cases, the capsule can be selectively incised and released without being fully removed. This is a more conservative procedure, applied selectively only where the clinical findings are appropriate.

Implant Pocket Repositioning

In some cases, it is advisable to change the position of the implant – for example, from a subglandular (above the muscle) to a submuscular or dual-plane position. This significantly reduces the likelihood of capsular contracture recurring and improves the long-term aesthetic result.

Next-Generation Implants

Following capsule treatment, you will receive cohesive silicone implants with a nanotextured surface from leading European manufacturers. These implants carry a significantly improved safety profile compared to older, heavily textured or smooth models, and offer a more natural appearance and movement. They come with a lifetime manufacturer’s guarantee.

All implants are placed using the Keller Funnel® – a sterile, no-touch insertion system that minimises friction and the risk of bacterial contamination. This “no-touch” approach is a key element in preventing capsular contracture from recurring.

All capsular contracture procedures at Dr. Kelly® are performed under gentle twilight sedation – tailored to the complexity of your individual case and your personal preferences.

Our anaesthesia specialists work with precisely calibrated, low-dose protocols that ensure complete relaxation and excellent pain control – without the typical after-effects of conventional general anaesthesia, such as nausea or disorientation.

You breathe spontaneously throughout the procedure, and your vital signs are continuously monitored. After the operation, you recover in our private recovery area before being discharged home the same day.

The procedure takes place on an outpatient basis in our AQC-certified operating theatre and typically lasts between 1.5 and 2.5 hours, depending on the findings and chosen technique.

• Your surgeon reopens the same incision line used in your original operation – typically in the breast fold – to avoid new scarring.
• The existing implant is removed and the capsule carefully assessed.
• Depending on the findings, either a capsulotomy (incision and release) or a total capsulectomy (complete removal of the capsule) is performed.
• If required, the implant pocket is repositioned or moved to a more favourable anatomical plane.
• The new implant is placed using the Keller Funnel® in a sterile, no-touch manner.
• The incision is closed with fine, absorbable sutures. A light compression dressing and a soft compression bra secure the position.

Intraoperatively, we use sterile irrigation solutions and a specific antibiotic prophylaxis to reduce the risk of capsular contracture recurring to a minimum.

In most cases, we use the same incision line as your original breast surgery. The scar sits deep within the breast fold and follows the natural contour – it is virtually invisible when standing upright.

Through our Minimal Scarring Technique (MST), fine absorbable sutures, and our structured post-operative scar management programme – comprising specialised scar products, light therapy, PRP, and optional laser treatment – we consistently achieve very discreet outcomes. Most scars fade within a few months to a barely visible pale line.

Recovery time following a capsular contracture procedure is individual and depends on the severity of the condition and the chosen surgical technique. In most cases, however, recovery is very manageable.

• First days: Mild swelling, a feeling of tightness and slight pressure are normal and subside quickly. Pain medication is rarely needed.
• 1–2 weeks: Return to light everyday activities. Sedentary tasks are generally possible from day 3–5.
• 3–4 weeks: Sport, heavy lifting, and intense physical activity should be avoided until this point.
• 3–6 months: The final result becomes apparent: soft, symmetrical, natural. The implants have fully settled.

Regular follow-up appointments at Dr. Kelly® ensure that healing and results develop as planned. All post-operative check-ups are included in our price – including additional visits if required.

Prices at Dr. Kelly® for a breast implant exchange due to capsular contracture start from CHF 11’600.–. The exact price depends on the severity of the capsular contracture, the chosen procedure (capsulotomy vs. total capsulectomy), and any complementary treatments such as a breast lift or fat transfer.

During your personal consultation, we will define the most appropriate treatment plan together and provide a transparent, binding quote. No hidden costs, no unexpected charges. Flexible instalment payments are available from CHF 125 per month.