Introduction: Capsular contracture is a known complication of breast augmentation. Smokers have been shown to have increased risk of capsular contracture after implant breast reconstruction. This purpose of this study is to determine whether there is a direct relationship between smoking and capsular contracture in cosmetic breast augmentation.

Methods: The charts of 422 consecutive breast augmentation patients were reviewed. Charts with a minimum 6 month follow-up were reviewed for smoking history, and documentation of capsular contracture.

Results: Of 422 consecutive patients who underwent breast augmentation, 98 were excluded. Of the 324 remaining, there were 88 smokers (27%), and 236 non-smokers (73%). Of the 176 augmented breasts in smokers, there were 25 capsular contractures in 15 patients (14%). Of the 472 augmented breasts in non-smokers, there were 45 capsular contractures in 27 patients (9.5%). This yielded a p-value of 0.20.

Discussion: Based on previous evidence that smoking is associated with a higher incidence of capsular contracture following implant breast reconstruction, we expected to find an association of smoking with capsule formation in cosmetic breast augmentation. The p-value of 0.20 was not significant.

Conclusion: There does not appear to be an increased risk of capsular contracture in smokers following cosmetic breast augmentation.