Absence of Capsular Contracture in 319 Consecutive Augmentation Mammaplasties: Dependent Drains As A-Possible-Factor

Abstract

N Fanous, I Salem, C Tawilé, AE Bassas. Absence of capsular contracture in 319 consecutive augmentation mammaplasties: Dependent drains as a possible factor. Can J Plast Surg 2004;12(4):193-197. Capsular contracture is one of the major complications of augmentation mammaplasty. A review of 638 augmented breasts in 319 consecutive patients who underwent primary augmentation, with an average follow-up of 17.2 months and without a single case of capsular contracture of any degree to date, is presented, along with a discussion of the surgical technique and complications, and an analysis of measures used to prevent capsular contraction. Each patient received a pair of smooth saline-filled implants (Mentor, USA) placed in the submuscular space through an inframammary incision. In all operated breasts, many of the known measures commonly used for capsular contracture prevention were implemented. As well, a dependent drain was used as the final hemostatic step to prevent blood accumulation in the pocket. Leaving a dependent drain in the dissected pocket overnight, as one of the sequence of measures aimed at eliminating blood accumulation, is believed to be a contributing factor in capsular contracture prevention.Key Words: Augmentation mammaplasty; Drains; Prevention of capsular contractionAbsence de contracture capsulaire dans 319 augmentations mammaires consécutives : Rôle possible des drains chirurgicaux La contracture capsulaire est l'une des importantes complications de l'augmentation mammaire. On présente ici une revue de 638 augmentations mammaires chez 319 patientes consécutives ayant subi une première augmentation, avec suivi moyen de 17,2 mois, sans un seul cas de contracture capsulaire quel qu'il soit à ce jour; la présentation s'accompagne d'une description de la technique chirurgicale, de ses complications et d'une analyse des mesures utilisées pour prévenir la contracture capsulaire. Chaque patiente a reçu une paire d'implants lisses de sérum physiologique (Mentor, U.S.A.), placés dans l'espace sous-musculaire au moyen d'une incision inframammaire. Dans tous les seins opérés, les mesures connues et couramment utilisées pour prévenir la contracture capsulaire ont été appliquées. De même, un drain chirurgical a été installé comme étape hémostatique finale pour prévenir l'accumulation de sang dans la poche. Parmi les mesures visant à éliminer l'accumulation de sang dans la poche disséquée, l'installation d'un drain chirurgical jusqu'au lendemain serait un facteur propice à la prévention de la contracture capsulaire. C apsular contracture is a particularly frustrating problem for everyone concerned with breast augmentation: the surgeon, the patient and the manufacturer. It is virtually the single major complication of prosthetic use, yet has stubbornly resisted solutions despite more than 25 years of persistent clinical and laboratory investigation (1,2).Because sound etiological evidence has been lacking, many different theories have been advanced to explain capsular contracture: blood accumulation in the...

Is a Closed-Suction Drain Advantageous for Penile Implant Surgery? The Debate Continues

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Povidone-Iodine Combined With Antibiotic Topical Irrigation to Reduce Capsular Contracture in Cosmetic Breast Augmentation

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Use of BioPatch® (Protective Disk with Chlorhexidine Gluconate) in Closed-Suction Drainage for Penile Implant Surgery

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