Capsular contracture around saline-filled and textured subcutaneously-placed imp

[Guest guest]

J Plast Reconstr Aesthet Surg. 2006;59(1):27-34.

http://eutils.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=16482787 & itool=pubmed_

DocSum

Capsular contracture around saline-filled and textured

subcutaneously-placed implants in irradiated and non-irradiated

breast cancer patients: five years of monitoring of a prospective

trial.

Benediktsson K, Perbeck L.

Department of Surgery, Karolinska University Hospital, 171 76 Solna,

Sweden. krispetben@...

One hundred and seven breast cancer patients underwent subcutaneous

mastectomy and immediate reconstruction with a subcutaneously-

placed, round, saline-filled prosthesis with a textured surface. The

primary aim of this prospective study was to determine the frequency

of capsular contracture in both irradiated and non-irradiated

breasts after this operation. Two different types of round implants

with different pore sizes on their textured surfaces, Siltex and

Microcell, were randomly chosen. Twenty-four patients received

radiotherapy within the first year following the operation. Capsular

contracture was measured by the Baker/Palmer classification and by

applanation tonometry at regular intervals for 5 years or as long as

the patients lived (median 60 months). Twenty-two patients (20.6%)

developed capsular contracture, defined as Baker three or four.

Sixteen of those were reoperated, 15 with open capsulotomy with or

without implant exchange, one with closed compression capsulotomy,

and monitored thereafter for 5 years or until death (median 60

months). All 107 patients could be monitored for 2 years, while 87

reported for the 5-year follow-up. The rate of capsular contracture

was significantly higher (p=0.01) for irradiated breasts than for

non-irradiated ones, 41.7 and 14.5%, respectively. It was slightly

higher (p<0.05) for large-pore implants than for those with smaller

(and more numerous) pores. There was a good correlation between the

two different methods for measuring capsular contracture. None of

the 16 reoperated patients had a recurrence of capsular contracture

within 5 years. The results indicate a high rate of capsular

contracture after this operation, especially when followed by

radiation. However, a fairly simple procedure to treat capsular

contracture seems to give good long-term results.