Capsular Contracture Treatment in Atlanta, Buckhead & Sandy Springs

Capsular contracture is one of the most common complications associated with breast implants. After any implant is placed, the body forms a thin layer of scar tissue—called a capsule—around the implant. In most patients, that capsule stays soft and flexible. In others, the capsule thickens and tightens, which can make the breast feel firm, look distorted, and sometimes become uncomfortable or painful.

At Kavali Plastic Surgery and Skin Renewal Center in Atlanta—serving Buckhead and Sandy Springs—board-certified plastic surgeon Dr. Carmen Kavali offers a comprehensive, medically responsible approach to diagnosing and treating capsular contracture. Treatment can range from careful monitoring and symptom relief in mild cases to advanced surgical correction, such as capsulectomy and implant exchange, when contracture is more significant. The goal is to restore comfort, improve breast shape, and reduce recurrence risk as much as safely possible. Individual results vary.

If you have breast implants and notice progressive firmness, changes in shape, asymmetry, discomfort, or a “high-riding” implant, an evaluation is often the right next step. You may be a good candidate for capsular contracture treatment if you:

• Have increasing firmness in one or both breasts
• See visible distortion (rounding, tight appearance, implant shifting upward, rippling changes)
• Experience discomfort, pressure, tightness, or pain
• Suspect an implant rupture or deflation (which can sometimes mimic contracture symptoms)
• Previously had contracture and are concerned about recurrence

Capsular contracture can occur months or years after surgery. Some cases develop earlier, especially if there is inflammation, bleeding, fluid collection, or infection in the early postoperative period. During consultation, Dr. Kavali will also review your implant history and any factors that can influence surgical planning—such as previous revisions, radiation therapy (for reconstruction patients), and your tissue quality.

Your consultation is built around clarity and individualized decision-making. You’ll review your surgical and medical history, including when your implants were placed, what type they are (saline vs. silicone), where they are positioned (above or below the muscle), and whether you’ve had any postoperative complications.

Dr. Kavali will examine your breasts for firmness, implant mobility, symmetry, and visible contour changes. A key part of evaluation is grading contracture severity using the Baker scale:

• Grade I: Breast feels soft and looks natural (normal capsule)
• Grade II: Breast feels slightly firm but looks normal
• Grade III: Breast is firm and looks distorted
• Grade IV: Breast is hard, painful, and visibly misshapen

If imaging is appropriate, Dr. Kavali may recommend ultrasound or MRI to evaluate implant integrity, rule out fluid collections, and clarify whether rupture or other issues are contributing to your symptoms.

You’ll also talk through your goals: Do you want to keep implants and improve comfort and shape? Are you considering a smaller implant, a different implant position, or removal without replacement? If you are exploring options, you may find it helpful to review related procedures such as breast implant revision and breast implant removal.

In Baker Grade III and IV cases, the capsule is often tight enough that lasting correction usually requires surgery. When surgery is indicated, many patients benefit from addressing the capsule and the implant in the same operative session. This is often because the capsule itself can distort the implant pocket, and the implant may no longer be well-positioned or appropriately sized for the tissue envelope.

Depending on your goals and anatomy, treatment may involve:

• Capsule correction: releasing or removing scar tissue to restore a healthier pocket environment
• Implant exchange: replacing implants to update size, type, or profile
• Pocket adjustment: improving the implant plane or stabilizing the pocket for better long-term positioning
• Optional reshaping: in select cases, a lift may be discussed if skin laxity or nipple position needs correction

Combining steps can reduce the number of anesthesia events and consolidate recovery. However, surgical planning must be tailored carefully to your tissue quality and medical history. Individual results vary.

1) Confirming the Diagnosis: Contracture vs. Rupture vs. Other Causes

Firmness and pain can be caused by multiple issues, including capsular contracture, implant rupture, inflammation from fluid collections, or implant malposition. Imaging can be helpful in many cases, especially for silicone implants where rupture may be “silent.” A precise diagnosis helps avoid incomplete treatment and supports safer surgical planning.

2) Capsule Strategy: Capsulotomy vs. Capsulectomy

The capsule is the scar tissue that forms around the implant. When treating capsular contracture, Dr. Kavali may recommend one of several approaches based on contracture severity, implant condition, and safety considerations:

• Capsulotomy: controlled release (opening) of the capsule to reduce tightness and improve implant position
• Partial capsulectomy: removal of the tightest or thickest portions of capsule tissue
• Total capsulectomy: removal of the entire capsule, creating a “fresh” pocket environment (case-dependent)
• En bloc capsulectomy: removal of the implant and capsule together as one unit in specific situations where clinically indicated

It’s important to know that capsule management is not “one-size-fits-all.” In some patients, extensive capsule removal may increase surgical risk and is not automatically the safest option. Dr. Kavali will explain what is medically appropriate for your specific case.

3) Pocket Position: Above vs. Below the Muscle (and Conversion When Needed)

Implant placement can influence long-term contracture risk. In general, submuscular (under the pectoralis muscle) placement has historically been associated with lower capsular contracture rates compared to subglandular (above the muscle) placement in many cosmetic augmentation cases. If your implants are currently above the muscle and you have recurrent or significant contracture, Dr. Kavali may discuss pocket conversion as part of your revision plan—if your anatomy supports it.

4) Implant Selection and Long-Term Maintenance Considerations

If you keep implants, you’ll choose implant type (saline vs. silicone), size, and profile. Dr. Kavali will focus on a proportional result that respects your base width and tissue characteristics. If you are concerned about implant-related risks or want to avoid future implant maintenance, implant removal (with or without reshaping) may be an option to discuss. You can explore implant removal here: breast implant removal.

When capsular contracture is significant (often Baker Grade III or IV), surgical correction is commonly the most definitive treatment. While the plan is individualized, many procedures include the following steps:

1. Anesthesia & preparation: Surgery is typically performed under general anesthesia in an accredited surgical setting with appropriate monitoring.

2. Incision planning: In many cases, Dr. Kavali can use a prior incision (such as inframammary or periareolar) to limit additional scarring, though this depends on anatomy and access needs.

3. Implant removal or exchange: The implant is removed and either replaced or not replaced, depending on the plan.

4. Capsule correction: Capsulotomy and/or capsulectomy is performed to address the constricting scar tissue.

5. Pocket revision: The implant pocket may be adjusted for position, symmetry, and stability. In select cases, reinforcement materials may be discussed to support pocket control and reduce recurrence risk.

6. Implant placement (if chosen): A new implant is placed with careful positioning and sterile technique.

7. Closure & dressing: Layered closure supports healing and scar quality. A supportive surgical bra may be applied.

Procedure duration varies based on complexity—particularly if pocket conversion, extensive capsule work, or additional reshaping is required.

Most patients go home the same day with a responsible adult. Expect swelling, soreness, and tightness early on—especially if capsule removal is performed. Your postoperative plan may include:

• A supportive surgical bra worn as directed
• Activity restrictions and lifting limits
• Incision care and showering guidance
• Medication instructions and safe pain control strategies

In some cases, drains may be used depending on the extent of capsule removal and pocket work. If drains are part of your plan, you’ll receive detailed instructions for care and follow-up.

Recovery varies depending on the extent of contracture and the surgical plan (release vs. partial/total capsulectomy, implant exchange, pocket conversion, and so on). Many patients experience the most noticeable discomfort and swelling in the first 1–2 weeks, with steady improvement after that.

• Week 1: Rest, light walking, swelling management, and incision monitoring
• Weeks 2–3: Many patients return to desk work depending on comfort; activity remains limited
• Weeks 4–6: Gradual return to exercise as cleared; chest-focused workouts often delayed longer
• Months 2–6: Breast shape continues to refine as swelling resolves and tissues settle

Dr. Kavali will provide a personalized aftercare plan, including scar care and timing for resuming physical activities. Following instructions closely is one of the most important ways to support healing and reduce recurrence risk. Individual results vary.

All surgery carries risk. Capsular contracture correction may include considerations such as:

• Bleeding, infection, delayed wound healing
• Fluid collections (seroma) or hematoma
• Changes in nipple or breast sensation (temporary or, less commonly, prolonged)
• Asymmetry or contour irregularities
• Scarring concerns
• Implant-related risks if implants are retained or replaced
• Recurrence of capsular contracture (risk varies by individual factors and history)

Because capsular contracture can recur, Dr. Kavali will discuss strategies that may reduce risk—while also emphasizing that no technique can guarantee prevention for every patient. Individual results vary.

After treatment, many patients report improved comfort and a softer feel when contracture is successfully corrected. Long-term maintenance is a combination of good surgical planning and healthy habits, including:

• Monitoring for changes in firmness or breast shape over time
• Wearing supportive bras during exercise
• Maintaining stable weight, as significant fluctuations can affect breast tissues
• Protecting scars from UV exposure during early healing
• Keeping up with routine breast screening and disclosing implant history to imaging providers

If you keep implants, Dr. Kavali will also discuss long-term implant considerations and when follow-up imaging may be appropriate based on your implant type and history.

Capsular contracture correction is revision surgery, and revision work often demands an extra level of planning and technical precision. In addition to aesthetic judgment, safe management of scar tissue and pocket stability are essential for comfort and long-term results.

When selecting a surgeon, many patients look for board certification and an accredited facility. You can learn more about board certification standards through the American Board of Plastic Surgery and the American Board of Medical Specialties. You may also explore the practice’s photo gallery for an idea of aesthetic style and consistency: Before & After Photos. Individual results vary.

Capsular contracture treatment cost in the Atlanta area can vary widely based on contracture severity, whether capsulectomy is needed, whether implants are exchanged or removed, facility and anesthesia fees, and whether additional reshaping is performed. Many revision cases fall within an approximate range of $7,500 to $18,000+, though your total may be lower or higher depending on complexity.

Your consultation will clarify what is included in your estimate and which components may affect overall cost. Financing options may be available for qualified patients. Learn more here: patient financing.

If you’ve noticed breast firmness, discomfort, or visible changes in shape after implants, earlier evaluation can simplify treatment planning and help you understand your options—whether that is monitoring, capsule release, capsulectomy with implant exchange, or implant removal without replacement.

To schedule a consultation at Kavali Plastic Surgery and Skin Renewal Center (serving Atlanta, Buckhead, and Sandy Springs), call 404.250.3333, email info(at)drkavali(dotted)com, or request an appointment online via the contact page.