At What Grade Does Capsular Contracture Become a Revision Case?
Revision typically enters the discussion at Baker grade III or IV — when the breast looks distorted or hurts — while softer, lower grades are often simply monitored.
Every implant is wrapped in a capsule of scar tissue, and in some patients that capsule tightens. Surgeons grade the firmness on the four-step Baker scale, and the grade — together with symptoms — frames the revision decision.
Reading the Baker scale like a surgeon
Grades I and II describe a breast that looks normal — soft in grade I, somewhat firm in grade II. Because surgery has its own risks and contracture does not always progress, these lower grades are usually observed rather than operated on. Grade III adds visible distortion and grade IV adds pain; these are the stages where capsulectomy with implant exchange or removal is commonly proposed.
The grade is a conversation starter, not a verdict: a grade III breast that does not trouble the patient may be watched, while a symptomatic grade II may warrant earlier imaging. How contracture progresses varies by individual, so the operate-or-observe call belongs in a consultation with a board-certified plastic surgeon.
MediIndex articles are for general information only and are not medical advice, diagnosis, or advertising. Outcomes vary by individual — consult a board-certified specialist for personal decisions.