Capsular contracture rate in a low-risk population after primary augmentation mammaplasty

Document Type

Article

Abstract

BACKGROUND: The safety of augmentation mammaplasty has increased dramatically in the past 20 years. Capsular contracture (CC) is the most commonly reported complication of augmentation mammaplasty. OBJECTIVES: The authors report the incidence of CC in a low-risk patient population after primary augmentation. METHODS: The authors retrospectively reviewed the charts of 856 consecutive patients who underwent primary augmentation mammaplasty between 1999 and 2009. This series did not include patients who underwent breast augmentation-mastopexy, secondary augmentation, revision, and/or reconstruction. Data points included demographics, functional and aesthetic outcomes, complications, and revision rate/type. RESULTS: The overall incidence of CC in 856 patients was 2.8%. Average follow-up time was 14.9 months. Antibiotic irrigation decreased CC rates from 3.9% to 0.4% (P = .004). Tobacco users had higher rates of contracture than nonsmokers (5.5% vs 1.9%; P = .036). Saline implants had a higher CC rate than silicone gel (4.3% vs 1.3%; P = .032). Using multivariate logistic regression, CC was 7.89 times more likely in saline implants than in silicone gel (P = .027, 95% confidence interval, 1.26-49.00). CONCLUSIONS: Based on our findings, it is apparent that the early CC rate in primary augmentation can be less than 1%. To avoid CC, we advocate an inframmamary approach, submuscular implant placement, and antibiotic irrigation of the breast pocket. LEVEL OF EVIDENCE: 3.

Medical Subject Headings

Adolescent; Adult; Age Distribution; Aged; Breast Implantation (adverse effects, methods); Breast Implants; Cohort Studies; Female; Follow-Up Studies; Humans; Implant Capsular Contracture (diagnosis, epidemiology); Incidence; Logistic Models; Mammaplasty (methods); Middle Aged; Multivariate Analysis; Postoperative Complications (diagnosis, epidemiology); Prosthesis Failure; Retrospective Studies; Risk Assessment; Time Factors; Treatment Outcome; Young Adult

Publication Date

5-1-2013

Publication Title

Aesthetic surgery journal

E-ISSN

1527-330X

Volume

33

Issue

4

First Page

516

Last Page

21

PubMed ID

23636624

Digital Object Identifier (DOI)

10.1177/1090820X13484465

Link to Full Text

Share

COinS