Systematic Review of Capsular Contracture Management Following Breast Augmentation: An Update

Abstract

Background: Capsular contracture is one of the most frequent indications for revision following breast augmentation. Management goals focus on restoring breast aesthetics and minimizing subsequent recurrence of capsular contracture. As new data emerge, close review of the data are merited to build evidence-based clinical guidelines to inform surgical practice and management of capsular contracture. Methods: A systematic review of the MEDLINE, Embase, and Cochrane Database of Systematic Reviews databases was conducted to characterize the surgical management of capsular contracture in revision breast augmentations. The primary endpoint was capsular contracture recurrence rate. Results: The review was conducted in November of 2021. Primary search revealed 14,163 results. Initial screening by title left 1223 articles. Abstract review left 90 articles for full-text review, of which 34 were ultimately included and were all observational in nature. Conclusions: Capsular contracture management remains an important topic, with limited high-level evidence for establishing clear evidence-based treatment guidelines. Although more evidence is required to assess the effects of capsulectomy, implant exchange, and plane change, these appear to be useful mechanisms for reducing recurrent capsular contracture. There is more evidence regarding the use of acellular dermal matrix, although this still requires long-term follow-up studies. New developments regarding textured implants limit the revision breast augmentation surgeon to smooth devices.

Risk factor analysis and clinical experience of treating capsular contracture after prepectoral implant-based breast reconstruction

“…Whether to perform partial or total capsulectomy was decided on the surgical field according to capsule thickness, degree of contracture and amounts of taken ADM. In a systematic review, it was evident that capsulectomy had potential for treating capsular contracture ( 27 ). This systematic review also presented many evidences of lower recurrence rates in studies exchanging implants after capsular contracture.…”

“…This systematic review also presented many evidences of lower recurrence rates in studies exchanging implants after capsular contracture. Using initial implant in the same pocket had high capsular contracture recurrence rates ( 27 , 28 ). Thus, it is not recommended.…”

Models for Implant-Induced Capsular Contracture Post Breast Cancer Surgery

“…The lowest recurrence rates occur if the entire capsule is removed and the implant is placed in a new anatomic plane relative to the original placement (Boyd et al. 2023 ). In a retrospective study, Montemurro et al.…”

Brustimplantat assoziiertes Plattenepithelkarzinom (BIA-SCC) – eine systematische Literaturübersicht

“…35 Millionen Implantate geschätzt [3] während weltweit jährlich über 1,5 Millionen neue Implantat-basierte Brustvergrößerungen erfolgen [4]. Eine der häufigsten Komplikationen stellt die Kapselfibrose dar [5]. Unmittelbar nach dem Einsetzen bildet sich durch eine Fremdkörperreaktion mit akuter und chronischer Entzündung eine Kapsel um das Implantat.…”