Capsular Contracture: Part II
In a previous submission I talked about the causes of capsular contracture. Going into more detail, there is an entire grading system (called the Baker Grading System) for capsular contracture based on the severity. The system has 4 grades, from 1 to 4, with Grade 1 being normal and Grade 4 the most severe. The interesting thing is that there is no Grade 0. This means that capsules are normal.
- Baker Grade I – The breast is soft and looks natural.
- Baker Grade II – The breast is a little firm, but looks normal.
- Baker Grade III – The breast is firm and is beginning to get distorted in shape.
- Baker Grade IV – The breast is hard, and has become very distorted in shape. Pain/discomfort and sometimes temperature changes are associated with this level of capsule contracture.
Grade 1 breasts are normal and need no intervention. Grade 2 breasts will need more aggressive breast massaging. Anecdotally, I have had some success with placing these patients on a short course of medrol, antibiotics, and anti-inflammatory medications, especially when caught early. Grade 3 breasts usually need revision surgery and 4 breasts always need revision surgery. To learn more about breast implants and capsular contracture and to view before and after pictures visit my website at drdadvandplasticsurgery.com.