Capsular contraction after a breast augmentation

Author: Dr Ahmed Hussien

Capsular contracture is the most common complication following breast augmentation surgery. This literature review has attempted to outline some of the recent research regarding capsular contracture after breast augmentation surgery in order to identify the risk factors and potential management strategies. From the current literature, it would appear that capsular contracture is a multifactorial process which involves inflammatory processes which then cause a fibrotic reaction in the tissue surrounding the implant, although the precise trigger and the reason why this happens is still not clear. Despite this, risk factors have been identified. From the currently available research, it appears that smooth implants, placed in a subglandular position have the biggest risk of developing capsular contracture. Learn more about the capsular contraction in the article of Dr. Ahmed Hussien from Giza.

How to stop capsular contraction before it begins?

Medical treatment of symptomatic cases seems to be ineffective and surgical therapy is associated with a significant rate of recurrence. However, there is a flurry of promising new research attempting to elucidate new management strategies or prophylactic strategies attempting to stop capsular contracture before it begins. The use of acellular dermal matrices has received the most attention but the new research looking at autologous fat transfer or use of implants with lower incidence rates such as those coated in polyurethane shows promising results. More research in these areas needs to be undertaken in order to find the best possible method to avoid the possible reoperation and explantation.

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Factors of incidence of capsular contracture

The results of this review can add to current clinical practice by providing more information to women about the risks regarding breast augmentation surgery and help towards fully informed consent. In the future, it is recommended that a thorough meta-analysis is carried out which takes into account all the factors that can affect the incidence of capsular contracture: the anatomical placement of the implant, the surface texture of the implant and the core type of the implant as well as a history of radiotherapy with regard to the breast.


Capsular contracture, breast implants 

Prevention of capsular contracture

Reconstruction and radiotherapy have been identified as independent risk factors for capsular contracture, and more research should be carried out in order to establish the amount of risk conferred. In addition, new strategies for preventing and treating capsular contracture need to be evaluated in large patient population studies in order to evaluate their real life benefits. Due to the fact that the immune system is involved in the pathogensis, future research should also focus on the possibility of biological profiling in order to identify women at an increased risk of capsular contraction and therefore offer them the best possible treatment with the lowest possible risks.

Updated: 2018-08-14

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