Answer:
This classification was devised in 1975 as a way to grade the severity of capsular firmness and contracture after augmentation.
Grade I: no palpable capsule. The augmented breast feels as soft as an unoperated one.
Grade II: minimal firmness. The breast is less soft and implant capsule can be palpated but not visible.
Grade III: moderate firmness. Breast is harder and implant easily palpated. Some distortion can be seen.
Grade IV: severe contracture. Breast is hard, tender, painful, and cold. Distortion is marked.
The classification has been modified to describe implants used for reconstruction and includes a Grade IB: implant is detectable by exam secondary to mastectomy. In this modified schema only Grade IV represents a poor outcome.