A capsule is a normal physiological response to any foreign body. So whether you have a breast implant, an Implanon implant, a heart valve or a joint replacement, the body will form a thin membrane around the device or implant. In many ways, this is protective as it seals off the implant from the body and the body from the implant. In a small number of patients, the capsule can become hard and uncomfortable and even distort the shape of the breast. There are a number of theories as to why this may or may not occur. The truth is no one really knows the etiology. Some studies have shown that textured implants will decrease the risk of having a bad capsule as well as putting the implant under the muscle may also decrease the risk. The reality is the risk is very low, and I use all possible techniques to reduce the incidence of a capsule contracture as much as possible.