While the gears may be set into motion at the time of surgery by factors such as bacterial contamination, tissue trauma, or excessive bleeding, capsular contracture usually is not apparent for months later. Some patients will give a history of always being hard since the time of surgery or will describe one breast as having been bruised after surgery and never looking right. More typically, patients will describe one or both breasts becoming firmer and rounder over a period of weeks, usually during the first 6 months after surgery. Late capsular contracture can also develop, but most occur in the first year.