The cause of capsular contracture is unknown but the most current hypothesis is that is a subclinical bacterial infection. The current treatment of capsular contracture is the surgical removal of the scar tissue. Prevention is the key. The most helpful post operative way to prevent capsular contracture is early massage.
The biggest mistake is to wait weeks before starting the massage. The breast massage needs to start the next day after surgery when the pocket that has been created by the surgeon is still open and wide. Also a common mistake is how to massage the breasts. Very often the massage is done with too caution and it is too light. The patient is afraid that being too aggressive would hurt the final outcome. It is just the opposite. The purpose of the massage is to move the implant in the sub-muscular pocket so the implant needs to be displaced superiorly, laterally and centrally and the movement of the implant should be visible enough to create fulness in the direction of the push. It is important to move just the implant and not the breast tissue with it. A common mistake is to massage the breast tissue instead of moving the implant away from the breast tissue. The way to do it is to put the palm of the hand below or lateral to the breast, hold the lateral edge of the hand on the chest wall and bring the palm down toward the breast. This way only the implant will be displaced and you can notice it by creating a fullness in the upper and central quadrant of the breasts. There are on line some helpful live demonstrations, but some of them are not correct. It is important to have the plastic surgeon tech the patient how to do it before the surgery and 1-2 days after even if the breasts are still sore. Starting early and do it aggressively ids the key to prevent capsular contracture.