Capsular contracture is a common complication associated with breast augmentation surgery. It is a condition where the scar tissue that forms around the breast implant becomes tight and constricts the implant, causing it to become hard, misshapen, painful, and in severe cases, cause the implant to rupture or shift position. While the exact cause of capsular contracture remains unknown, several factors have been associated with its development.

1. Implant Placement: The placement of the implant can play a significant role in the development of capsular contracture. If the implant is placed in an area where there is a lot of tension on the breast tissue, such as under the muscle, it can cause the body to produce more scar tissue in an attempt to protect itself. This increased scar tissue can lead to capsular contracture.

2. Infection: Infections that occur after the breast augmentation surgery can increase the risk of developing capsular contracture. The bacteria that cause the infection can trigger an immune response from the body, leading to the formation of excessive scar tissue.

3. Bleeding: Bleeding that occurs during surgery or afterward can lead to the formation of blood clots that can trigger an immune response from the body, leading to the formation of excess scar tissue.

4. Implant Type: The type of implant used can also play a role in the development of capsular contracture. Textured implants have been associated with a higher risk of capsular contracture than smooth implants. It is believed that the rough surface of the textured implants can irritate the surrounding tissue, triggering the immune system to produce more scar tissue.

5. Genetics: Genetics can also play a role in the development of capsular contracture. Some people`s immune systems may react more strongly to foreign objects, such as breast implants, than others. This can lead to the formation of more scar tissue and an increased risk of capsular contracture.

6. Trauma: Trauma to the breast tissue, such as a fall or other injury, can cause the body to produce more scar tissue as part of the healing process. This scar tissue can lead to the development of capsular contracture.

In conclusion, the exact cause of capsular contracture remains unknown, but several factors have been associated with its development. These include implant placement, infection, bleeding, implant type, genetics, and trauma. Understanding these factors can help surgeons and patients take steps to reduce the risk of capsular contracture and mitigate its effects if it occurs.