It is well established that the capsule forms around the breast implant in the first four to six weeks of breast implantation. This is a normal process that occurs in every single patient. However, this capsule can progress into what we call a capsule contracture. In my experience, we see capsular contracture develop within the first two years after breast augmentation surgery. If the patient has not developed a capsular contracture within two to three years, she might not develop this complication for many years, unless a silicone implant was used. There are essentially three physical characteristics that I look for to determine if there is a capsular contracture. Number one, and the most important one, is firmness. After a silicone implant is placed, your breast is supposed to feel soft and natural. If your breast starts feeling firm, you might be having the early symptoms of capsule contracture. With a saline implant, it is a little more complicated, because this implant by itself feels firm. Your plastic surgeon will be able to determine if you in fact have a capsule contracture.The second physical finding is if your breast starts to develop an abnormal shape. First, the breast will start looking very round. This will be followed by the implant shifting upward and looking higher than normal. This is a more advanced level of capsule contracture. The final symptom of a capsule contracture is if your breasts are tender to touch and sometimes cold. This also indicates a contracture that is advanced and requires surgery. Understanding what symptoms you need to look for is extremely important for the management of capsular contracture, in the event that this occurs.