Differentiated surgery for capsular contracture after mammoplasty

Puchkov K.V.

Federal State Budgetary Educational Institution of Higher Education 'I.P Pavlov Ryazan State Medical University' of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia;
Federal State Budgetary Educational Institution of Further Professional Education 'Russian Medical Academy of Postgraduate Education' of the Ministry of Healthcare of the Russian Federation, Moscow, Russia;
'New Technologies Plus', Moscow, Russia

Sergeev I.V.

Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Faĭzullin T.R.

Kafedra khirurgicheskikh bolezneĭ i novykh tekhnologiĭ GBOU VPO "Bashkirskiĭ gosudarstvennyĭ meditsinskiĭ universitet" Minzdravsotsrazvitiia Rossii, Ufa

Rabodzey O.P.

Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Differentiated surgery for capsular contracture after mammoplasty

Authors:

Puchkov K.V., Sergeev I.V., Faĭzullin T.R., Rabodzey O.P.

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Journal: Plastic Surgery and Aesthetic Medicine. 2019;(2): 55‑58

DOI: 10.17116/plast.hirurgia201902155

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To cite this article:

Puchkov KV, Sergeev IV, Faĭzullin TR, Rabodzey OP. Differentiated surgery for capsular contracture after mammoplasty. Plastic Surgery and Aesthetic Medicine. 2019;(2):55‑58. (In Russ.)
https://doi.org/10.17116/plast.hirurgia201902155

Подписка 2025-2 (Plastic Surgery and Aesthetic Medicine)

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Objective — to determine the optimal approach for capsular contracture after primary augmentation mammoplasty. Material and methods. There were 92 patients with capsular contracture of various grades by Baker scale after primary mammoplasty. It was observational dynamic study. Duration of the study was 36 months (January 2016 — January 2019). Assessment of the severity of contracture was followed by capsulotomy or capsulectomy. The result of the study was estimated as a percentage of repeated capsulations. Postoperative follow-up period was 18 months. Results. Capsulotomy is advisable for capsular contracture grade 1 and 2 with primary submuscular deployment of the implant. This procedure is followed by favorable outcome without signs of redo encapsulation. Risk of redo encapsulation after capsulotomy is quite high (up to 10%) in the case of primary subglandular deployment of the implant and subsequent contracture grade 1 and 2. Capsulectomy with replacement of smooth-textured implants for coarse-textured ones is effective for capsular contracture grade 3 and 4 regardless primary deployment fashion. Conclusion. Capsulotomy and capsulectomy is advisable for capsular contracture during primary augmentation. A clear indication depending on the grade of capsular contracture and primary deployment of the implant is essential.

Keywords:

breast surgery

augmentation mammoplasty

capsular contracture

complications of mammoplasty

Authors:

Puchkov K.V.

Sergeev I.V.

Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Faĭzullin T.R.

Kafedra khirurgicheskikh bolezneĭ i novykh tekhnologiĭ GBOU VPO "Bashkirskiĭ gosudarstvennyĭ meditsinskiĭ universitet" Minzdravsotsrazvitiia Rossii, Ufa

Rabodzey O.P.

Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

List of references:

Dobryakova OB, Dobryakova BS, Kuznetsova NS. Early diagnostics of fibrous capsular contracture and prevention of its progression. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy hirurgii. 2016;4:27-31. (In Russ.)
Milanov NO, Startseva OI, Belova YuV. Problema kapsulyarnoy kontraktury posle endoprotezirovaniya molochnyh zhelyoz. Hirurgicheskaya korrektsiya kapsulyarnoy kontraktury. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy hirurgii. 2009;1:34-44. (In Russ.)
Johnson M. Breast implants: history, safety, and imaging. Radiol Technol. 2013;84:439-515.
Namnoum JD, Largent J, Kaplan HM, Oefelein MG, Brown MH. Primary breast augmentation clinical trial outcomes stratified by surgical incision, anatomical placement and implant device type. J Plast Reconstr Aesthet Surg. 2013;66:1165-1172.
Handel N, Cordray T, Gutierrez J, Jensen JA. A longterm study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg. 2006;117:757-767.
Spear SL, Baker JL. Classification of capsular contracture after prosthetic breast reconstruction. Plast Reconstr Surg. 1995;96:1119-1123.
Steiert AE, Boyce M, Sorg H. Capsular contracture by silicone breast implants: possible causes, biocompatibility, and prophylactic strategies. Med Devices (Auckl). 2013;6:211-218.
Barnsley GP, Sigurdson LJ, Barnsley SE. Textured surface breast implants in the prevention of capsular contracture among breast augmentation patients: a metaanalysis of randomized controlled trials. Plast Reconstr Surg. 2006;117:2182-2190.
Wong CH, Samuel M, Tan BK, Song C. Capsular contracture in subglandular breast augmentation with textured versus smooth breast implants: a systematic review. Plast Reconstr Surg. 2006;118:1224-1236.
Schaub TA, Ahmad J, Rohrich RJ. Capsular contracture with breast implants in the cosmetic patient: saline versus siliconea systematic review of the literature. Plast Reconstr Surg. 2010;126:2140-2149.
Poeppl N, Schreml S, Lichtenegger F, Lenich A, Eisenmann-Klein M, Prantl L. Does the surface structure of implants have an impact on the formation of a capsular contracture? Aesthetic Plast Surg. 2007;31:133-139.
Stevens WG, Nahabedian MY, Calobrace MB, Harrington JL, Capizzi PJ, Cohen R, D’Incelli RC, Beckstrand M. Risk factor analysis for capsular contracture: a 5year Sientra study analysis using round, smooth, and textured implants for breast augmentation. Plast Reconstr Surg. 2013;132:1115-1123.
Abramo AC, De Oliveira VR, LedoSilva MC, De Oliveira EL. How textureinducing contraction vectors affect the fibrous capsule shrinkage around breasts implants? Aesthetic Plast Surg. 2010;34:555-560.
Jacombs A, Tahir S, Hu H, Deva AK, Almatroudi A, Wessels WL, Bradshaw DA, Vickery K. In vitro and in vivo investigation of the influence of implant surface on the formation of bacterial biofilm in mammary implants. Plast Reconstr Surg. 2014;133:471-480.
Vazquez G, Pellon A. Polyurethanecoated silicone gel breast implants used for 18 years. Aesthetic Plast Surg. 2007;31:330-336.
Siggelkow W, Faridi A, Spiritus K, Klinge U, Rath W, Klosterhalfen B. Histological analysis of silicone breast implant capsules and correlation with capsular contracture. Biomaterials. 2003;24:1101-1109.
Pereira Leite L, Correia Sa I, Marques M. Etiopathogenesis and treatment of breast capsular contracture. Acta Med Port. 2013;26:737-745.
Forster NA, Kunzi W, Giovanoli P. The reoperation cascade after breast augmentation with implants: what the patient needs to know. J Plast Reconstr Aesthet Surg. 2013;66:313-322.
Lee HK, Jin US, Lee YH. Subpectoral and precapsular implant repositioning technique: correction of capsular contracture and implant malposition. Aesthetic Plast Surg. 2011;35:1126-1132.
Maxwell GP, Gabriel A. The neopectoral pocket in revisionary breast surgery. Aesthet Surg J. 2008;28:463-467.
Castello MF, Lazzeri D, Silvestri A, Agostini T, Pascone C, Marcelli C, Gigliotti D, D’Aniello C, Gasparotti M. Maximizing the use of precapsular space and the choice of implant type in breast augmentation mammaplasty revisions: review of 49 consecutive procedures and patient satisfaction assessment. Aesthetic Plast Surg. 2011;35:828-838.
Salgarello M, Visconti G, Farallo E. Autologous fat graft in radiated tissue prior to alloplastic reconstruction of the breast: report of two cases. Aesthetic Plast Surg. 2010;34:510.
Roca GB, Graf R, da Silva Freitas R, Salles G Jr, Francisco JC, Noronha L, Maluf I Jr. Autologous fat grafting for treatment of breast implant capsular contracture: a study in pigs. Aesthet Surg J. 2014;34:769-775.
Kornstein A. Porcinederived acellular dermal matrix in primary augmentation mammoplasty to minimize implantrelated complications and achieve an internal mastopexy: a case series. J Med Case Rep. 2013;7:275.
Hester TR, Jr, Ghazi BH, Moyer HR, Nahai FR, Wilton M, Stokes L. Use of dermal matrix to prevent capsular contracture in aesthetic breast surgery. Plast Reconstr Surg. 2012;130:126S-136S.
HilleBetz U, Kniebusch N, Wojcinski S, Henseler H, Heyl V, Ohlinger R, Paepke S, Klapdor R, Krause-Bergmann B. Breast reconstruction and revision surgery for implantassociated breast deformities using porcine acellular dermal matrix: a multicenter study of 156 cases. Ann Surg Oncol. 2015;22:1146-1152.

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