Classification of capsular contracture after prosthetic breast reconstruction.

The Baker classification of capsular contracture remains the most popular and practical method of assessing clinical firmness of the breast after augmentation mammaplasty. This classification system was never intended to describe prosthetic breast reconstruction. A modification of the Baker classification to include classes IA, IB, II, III, and IV has been developed to describe breast reconstruction more accurately. For this modified system, a soft but visible implant (class IB), an implant with mild firmness (class II), and an implant with moderate firmness (class III) could still be considered good or excellent outcomes. Only a class IV classification with an excessively firm and symptomatic breast resulting in a poor aesthetic result would necessarily be considered a poor outcome.