Semiquantitative measurements of capsular contracture with elastography--first results in correlation to Baker Score

To estimate the presence and severity of capsular contracture in patients after breast implants an objective measurement tool is necessary.

Eleven patients (range of age 37 to 53 years) who underwent cosmetic breast augmentation (seven patients with bilateral implants) or breast reconstruction by mammary asymmetry (four patients unilateral) with smooth silicone gel implants were included in this prospective study. In total seventeen implants were examined clinically and with the colour coded Ultrasound Elastography using a multifrequency probe (5-10 MHz Siemens Antares Premium VFX13-5). The grade of capsular contracture was assessed by two examiners with the palpation method and classified according to the Baker score. The Ultrasound Elastography was performed by two radiologists specialized in breast imaging and was correlated with the Baker score, colour coded ultrasound elastography and a high resolution ultrasound B-scan score (0-5).

The clinical examination proved following distribution of the Baker degree: 6 breast implants with Baker grade I and Baker grade II, 3 breast implants with Baker grade III and two breast implants with Baker grade IV. There was a high correlation between the Baker score and the objective scoring measured by Ultrasound Elastography (kappa 0.83-0.89).

The new technology of Ultrasound Elastography represents a useful tool to evaluate the compressibility of the peri-implant capsule, the implant and the surrounding tissue.