The development of hardening, pain and deformity over time following breast implant surgery is termed capsular contracture. If left untreated, the implants can fold and/or rupture. The risks vary from 5% to as high as 30% in some patients. Capsular contracture is the commonest reason for removal and replacement of breast implants.

There is now strong evidence to show that bacterial biofilm infection around implants is the leading cause of contracture. The use of the 14 point plan has been shown to reduce the risk of capsular contracture (and re-operation) significantly by reducing the risk of bacterial infection.