Prevention and correction of capsular contracture after breast augmentation

 is the most common complication after implant breast augmentationand one of the most common reasons for reoperation. Capsular contracture is caused by an excessive 

 to a foreign body (implant) and has an overall incidence of 10.6%. The risk factors that were identified included in yourself:

• subglandular placement of implants;
• use of saline implants;
• Previous breast radiation therapy.
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, and how to correct this complication.

• How to reduce the risk of capsular contracture after breast augmentation
• Features of the surgical technique for the prevention of capsular contracture
• Surgical correction of capsular contracture after breast augmentation
• Medication methods for eliminating capsular contractionry
How to reduce the risk of capsular contracture after breast augmentation

Breast augmentation is one of the most frequently performed cosmetic procedures. For mammoplasty 

are used, which are usually divided according to:

• surface textures (smooth or textured);
• gel used to fill the implant (usually saline or silicone).
 

, first introduced in 1961, now dominate the world market and this is reflected in the much larger range available for use. Silicone as a filler material has a number of advantages: it is believed that implants act more like natural breast tissues. Saline implants also offer a number of benefits. The main advantage is that saline implants 

. When such an implant with saline is ruptured, the liquid is absorbed into the body harmlessly. Read also: Capsular contracture can be triggered by smoking and exercise

Regarding the risk of capsular contracture, it has been found to occur in 20.8% of breast augmentation with saline implants, indicating a much higher risk than with silicone implants. The texture has also been found to implant surface affects the incidence of capsular contracture. Textured implants have been found to be associated with a lower risk of clinically significant capsular contracture.

 significantly reduce the risk of contracture, in particular, participants in one particular study found that when using such implants, caps

ula mimics the sensation  natural firmness of the breast. Features of surgical technique for the prevention of capsular contracture

implant, when placed behind the pectoralis major muscle, results in a lower incidence of capsular contracture than when the implant is placed directly under the skin. However, both placements can lead to contracture.

A recent systematic review found that the overall rates of capsular contracture with subglandular placement was 8.6%, while for submuscular placement it was only 2.8%. This suggests that the axillary implant placement technique should be preferred in order to reduce

the risk of possible complications.

Surgical correction of capsular contracture after breast augmentation Traditionally, capsular contracture is treated surgically, although it is important to note that treatment is only indicated for grade III and IV capsular contracture.

In fact, surgical treatment is associated with a significant risk of contracture recurrence, approaching 25% in the first year, which can lead to a cascade of procedures.

The most common surgical treatment 

.

Read also: Peculiarities of choosing implants for mammoplasty

Other surgical methods that have been discussed as strategies for treating capsular contracture include the use of autologous fat:

lipofilling

• fat graft, placed in the original implant pocket along with the half implant.
• In addition, there is recent evidence that autologous fat transfer can be used
van to correct capsular contracture by 

 peri-implant . Medicated methods for eliminating capsular contracture Although the exact etiopathogenesis of capsular contracture remains to be elucidated

  seems to play a role in this process. Therefore, it is believed that modulating the inflammatory response with drugs may reduce the incidence of capsular contracture.

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Telegram! The leukotriene antagonist Zafirlukast  was used off-label to investigate whether it affects the development of contracture. Animal studies have shown that when the drug is injected around textured silicone implants, the capsules form much thinner and with lower collagen density, indicating that the drug can prevent the development of capsular contracture.

Read also: The choice of implants for augmentation mammoplasty: what is important for plastic surgeons to remember

Botulinum Toxin A has been reported to be effective in reducing keloid scars. The implant capsules have been found to be histologically similar to these scars, so a recent study was conducted to see if this could reduce contracture volume or prevent it from developing. A study in rats injected with 0.5 ml (5 units) of botulinum toxin A into implant pockets showed that the capsule was reduced in thickness on histological analysis of the capsule after 6 weeks.

developed in Korea has also been studied for its effect on reducing the development of capsular contracture. Animal studies show promising results:

there was a decrease in the number of inflammatory cells.

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