Influence of patient age on capsular contracture after aesthetic breast augmentation

Abstract

The influence of age on capsular contracture rates remains unclear. Most studies have only investigated early capsule development and not whether a link between age at primary surgery and the later development of capsular fibrosis exists. To clarify whether patient age impacts the development of late capsular fibrosis, the authors conducted a retrospective case study involving 43 patients who presented for surgical revision of capsular contracture (Baker grade ≥III) between four and 40 years after primary breast augmentation. Possible correlations between age and implant placement were analyzed. Late presentation of capsular fibrosis occurred a mean of 15.6 years after primary augmentation, with a slightly negative, but not significant, correlation between age at primary operation and duration of implant placement. Patients <40 years of age underwent an operative revision after a mean of 18.9 years, while patients ≥40 years of age needed an operative revision a mean of 11.9 years after primary breast augmentation (P=0.0368). The results suggest that with advancing age, the average time to develop capsular fibrosis is significantly shorter in individuals who develop capsular contracture. As more data are collected, appropriate advice can be provided to patients regarding factors that influence the long-term outcomes of breast augmentation.

Revisions for Complications of Aesthetic Breast Surgery

“…Risk factors associated with the development of capsular contracture are a history of capsular contracture, subglandular implant placement, silicone rupture, smoking, bacterial contamination, and autoimmune disorders. Development of contracture is a continuous process that can present several years after implant placement [22].…”

Activin A and Follistatin Serum Concentrations in Breast Augmentation Patients

“…[1][2][3] In case of capsular contracture, the indication for revision surgery is usually given from Baker stages III/IV, whereby the incidence for capsular fibrosis of this degree is stated between 3.6% and 10.8% 4,5 after 10 years. The development of capsular contracture is subject to a multifactorial process that is influenced by numerous risk factors such as the implant, position, patient age, [6][7][8][9] or peri-and postoperative complications (eg seroma, hematoma, infection). 10,11 Overall, fibrosis, including capsular fibrosis, is characterized by a largely nonspecific tissue reaction in which activated fibroblasts increasingly produce interstitial connective tissue, which results in scarred changes that can lead to impairment or loss of organ function in the advanced stage.…”