Capsular contracture seems to be the outcome of prolonged inflammation. There are many causes of inflammation, which is the fancy name for the body’s response to irritation. It is believed that the inflammation underlying most capsular contractures is caused by bacteria stuck to the surface of the implant. These bacteria do not cause a infection per se, but linger on the surface of the implant. These bacteria group together and secrete something called “biofilm” which shields them from the body’s effort to destroy them. The result of this longterm battle is the build up of this scar tissue. Where do these bacteria come from? These bacteria normally inhabit the milk ducts that course through the breast. Other causes of contracture are thought to be blood in the pocket after surgery as a result of either excessive bleeding during or after surgery, irritants such as talc on surgical gloves, and a high burden of damaged tissue as a result of surgical trauma. There is a lot of active research going on about capsular contracture and we are learning more about it all the time.