A capsular contracture is when the normally thin, soft scar capsule around an implant becomes abnormal and thick, squeezing the implant and distorting the breast, sometimes painfully. You should treat it: you deserve a soft, pain-free breast, and there is a rare cancer, BIA-SCC, tied to the chronic inflammation, so at a minimum follow up regularly.
A photo of Doja Cat went viral this week because of an abnormal contour to her left breast, and, because the internet is the internet, people were not kind about it. She responded with a line I loved: "Don't clock my contracted implant, it's all I ask."
So we are not going to clock her. But I do want to use this moment to talk about capsular contracture, what it actually is, and why it matters, because she clearly knows exactly what's going on, and a lot of people watching may be dealing with the same thing. And I'll be honest: I love Doja, and I want to fix it for her so badly.
Whenever you place a foreign body anywhere in the body, whether it's a pacemaker or a breast implant, your body does something completely normal: it walls the object off with scar tissue. That capsule of scar tissue is usually thin and soft, and it causes no problems at all. That's the way it's supposed to go.
A capsular contracture is when that process goes wrong. The scar tissue around the implant becomes abnormal and thick. When that happens, the capsule can:
It's genuinely a terrible problem to live with, both because of how it can look and because it can be painful. If you want the deeper dive on why it happens, I've covered the causes, prevention, and treatment in detail.
Fixing a contracture can be challenging, but it absolutely can be done. In the operating room, there are several specific steps we take to restore your normal shape and minimize the chance it comes back. I have a whole revision playlist walking through this, and I've written about how I approach treating contractures and how I keep my recurrence rates low.
And a quick, relevant plug: I'm a principal investigator on an FDA trial for the treatment of capsular contractures. So this is something I care about deeply and work on directly. If that's something you're interested in, feel free to DM me.
Here's where I want to push back on some advice floating around out there. A lot of people will tell you that you don't have to do anything about a capsular contracture. I would argue you absolutely should address it, for two reasons.
First and most simply: you deserve to have a soft, non-painful breast. Don't let anyone convince you otherwise. If your implant is distorted, hard, or hurting, that is a real problem worth solving, not something you should just accept.
Second, and more seriously, there is a rare cancer associated with the chronic inflammation of a capsular contracture around breast implants, called BIA-SCC (breast implant–associated squamous cell carcinoma). It is rare, but it's real, and it's tied to that ongoing inflammatory state. You can read more about BIA-SCC and other implant-associated cancer risks here.
Because of that, if you have a contracture, it's important at a minimum to follow up regularly with your doctor for evaluation, even if you're not ready to do surgery. Don't just ignore it indefinitely.
Doja Cat handled a cruel internet moment with grace, and she's right that her contracted implant is nobody's business to mock. But for everyone learning from it: a capsular contracture is when the normally thin, soft scar capsule around an implant turns thick and abnormal, squeezing the implant, distorting the breast, and sometimes causing pain.
It can be fixed, with specific surgical steps to restore shape and lower the chance of recurrence. And you should address it, both because you deserve a soft, comfortable breast and because of the rare but real BIA-SCC risk tied to chronic contracture, which makes regular follow-up essential at the very least.
And Doja, if you're reading this, give me a call. I'll totally fix it for you.