An Innovative Procedure for the Treatment of Primary and Recurrent Capsular Contracture (CC) Following Breast Augmentation

Costagliola, M; Atiyeh, Bishara S.; Rampillon, Florence

doi:10.1177/1090820x13502035

Cited by 23 publications

(19 citation statements)

References 59 publications

(107 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Site change and implant exchange have recently been proposed as important options for treating capsular contracture 1 2 3 4 5 6 7 8 9 10 11 12 . The treatment algorithm of capsulectomy, site change, and implant exchange is only partially supported by clinical evidence.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

Park

Sim

2018

Arch Plast Surg

View full text Add to dashboard Cite

BackgroundDuring breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange.MethodsThis study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20–38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization.ResultsThe mean follow-up period was 14 months (range, 6–24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160–300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery.ConclusionsEndoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.

show abstract

Section: Discussionmentioning

confidence: 99%

“…When capsular contracture occurs after breast augmentation, site change and implant exchange may play an important role in treatment. However, the data on capsulectomy and capsulotomy are still controversial [1][2][3][4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

Park

Sim

2018

Arch Plast Surg

View full text Add to dashboard Cite

show abstract

“…10,[25][26][27][28] Upon recent evaluation of the literature by Wan and Rohrich, it was found that site change and implant exchange are, in fact, associated with reduced recurrence rates but the data on capsulectomy are less conclusive. [29][30][31][32][33][34][35][36] The emerging use of ADM in aesthetic breast surgery has been associated with consistently low capsular contracture recurrence rates ranging from 0% to 7%. 12,14,15,17,28 When site change was combined with the use of ADM, recurrence rates range from 0% to 2.6%.…”

Section: Discussionmentioning

confidence: 99%

A Novel Technique for Treatment of Recurrent Capsular Contracture Using Acellular Dermal Matrix in Aesthetic Revisional Breast Surgery

2018

View full text Add to dashboard Cite

Capsular contracture remains among the most commonly cited reasons for reoperation following implant-based breast augmentation. The introduction of acellular dermal matrix (ADM) in revision surgery has led to a decrease in the recurrence of capsular contracture. However, there remains a relative paucity of literature in secondary aesthetic surgery and its use is associated with increased patient costs. The authors describe a novel technique using segmental interpositional graft placement to treat and prevent contracture recurrence while decreasing additional costs to the patient. This study is a retrospective chart review of patients who presented with recurrent capsular contractures and underwent revision surgery by a single surgeon. Patient demographics, treatment history, and postoperative complications were recorded. Five patients (7 breasts) were identified. Mean age was 36 years old and mean body mass index was 20.6 kg/m 2 (range, 18.1-24.6 kg/m 2). All 5 patients had prior surgical treatment for capsular contractures with recurrence. Mean follow-up was 52.8 months (range, 36-60 months). One patient experienced a recurrence in an untreated pole of the breast. The remaining patients did not experience recurrent capsular contracture to date. Multiple studies have shown the benefit of using ADM in the prevention or treatment of capsular contracture. The author's technique may be an effective strategy to treat recurrent capsular contractures while decreasing the patients' out-of-pocket costs.

show abstract

“…Other studies of capsulectomy, all published after 2000, 3,17,25,26 evaluated women with third-generation implants. Costagliola et al 25 reported no recurrences after capsulectomies, but these patients were treated with steroids. Caffee 26 reported a recurrence rate of 30.7% after capsulectomy and subpectoral placement of new textured saline implants.…”

Section: Discussionmentioning

confidence: 99%

Open Capsulotomy: An Effective but Overlooked Treatment for Capsular Contracture after Breast Augmentation

Swanson

2016

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:The prevailing theory for capsular contracture after breast augmentation is a subclinical capsular infection. A capsulectomy, site change, and implant replacement are recommended. An open capsulotomy leaves the capsule in the patient. Theoretically, such a procedure would be ineffective because it does not remove the infected tissue. Recurrences occurred frequently in women treated in the 1970s when leaky silicone gel implants were in use. Open capsulotomy has not been studied in women implanted with third-generation devices.Methods:Seventy-five consecutive women with Baker III/IV capsular contractures after breast augmentation treated with open capsulotomies between 1996 and 2016 were retrospectively evaluated. The original implants were usually saline-filled (72.2%). Replacements were all smooth and round, and 92.6% were also saline-filled.Results:Seventeen women (22.7%) developed a recurrent capsular contracture. Two patients (2.7%) experienced a second recurrence. Patients with ruptured silicone gel implants (n = 13) had a significantly greater risk of recurrence (P = 0.01). There was no significant difference in recurrence rates comparing patients whose intact implants were reinserted (12.5%) with women whose intact implants were replaced (18.2%). Povidone–iodine irrigation did not affect the recurrence rate. Capsular contracture was corrected with 1 procedure in 77.3% of patients and 2 procedures in 97.3% of patients.Conclusions:Open capsulotomy is a safe and effective treatment that avoids the additional morbidity and cost of a capsulectomy. The findings challenge the infected biofilm theory of capsular contracture. Open capsulotomy deserves reconsideration by plastic surgeons.

show abstract

An Innovative Procedure for the Treatment of Primary and Recurrent Capsular Contracture (CC) Following Breast Augmentation

Abstract: This GC administration technique avoids the potential complications of long-term, slow corticosteroid release. It has a targeted anti-inflammatory effect, probably at a critical stage of the healing process, and could effectively prevent CC following alloplastic breast augmentation.

Cited by 23 publications

References 59 publications

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

A Novel Technique for Treatment of Recurrent Capsular Contracture Using Acellular Dermal Matrix in Aesthetic Revisional Breast Surgery

Open Capsulotomy: An Effective but Overlooked Treatment for Capsular Contracture after Breast Augmentation

Contact Info

Product

Resources

About