How are the four grades of capsular contracture told apart?
The Baker scale grades contracture from a soft, natural-feeling breast to one that is hard, distorted, and painful — and the grade is assigned by physical examination, not by a lab test.
Clinicians worldwide describe contracture with the Baker classification, a four-step scale built on how the breast feels and looks in the examination room. Knowing roughly how the grades work helps patients report changes accurately.
What each grade means
Grade I is a breast that looks and feels natural — the capsule exists but is not clinically noticeable. Grade II feels slightly firm while still looking normal, Grade III is visibly firm or distorted, and Grade IV adds pain or tenderness on top of hardness and distortion. Treatment discussions usually begin at Grade III.
Because grading rests on palpation, the same breast can be read a grade apart by different examiners, and firmness itself varies with tissue thickness from person to person. If you suspect your grade has moved, have it re-examined by a specialist experienced in revision surgery instead of tracking it alone.
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.