Baker – Classification of capsular fibrosis

The formation of scar tissue around breast implants is a natural reaction of the immune system to a foreign body. The scar tissue is called the capsular contracture.

In 1975, Orlando plastic surgeon James Baker described four degrees of capsular fibrosis (James L. Baker, Jr.: 1975 Symposium on Aesthetic Surgery of the Breast. Arizona). The decisive factor for distinguishing between the degrees of severity is the appearance of the breast, a palpable hardening of the breast and pain.


Baker’s classification is used worldwide. In stage I, the breast looks and feels normal. In stage II, the breast looks normal but feels somewhat firm. In stage III feels solid and begins to take on a spherical shape. In stage IV, the breast is disfigured and painful. The transitions between the stages are fluid.

Palpation examination depends on the experience of the examiner.

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