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Risk Factors for Capsular Contracture in Alloplastic Reconstructive and Augmentation Mammaplasty: Analysis of the
Aleeza Ali1, Omar Picado2, Prakash J Mathew2
1Herbert Wertheim College of Medicine; Florida International University, Miami, Florida, USA.
Aesthetic Plastic Surgery
|June 17, 2022
Summary
Capsular contracture after breast implants is common. Older, overweight, and cancer patients face higher risks. Discuss these factors during informed consent for breast augmentation.
Area of Science:
- Plastic Surgery
- Surgical Complications
- Biostatistics
Background:
- Capsular contracture is the most frequent complication following breast augmentation and reconstruction.
- It is theorized to result from an immune response, potentially leading to pain, aesthetic dissatisfaction, and the need for reoperation.
- Current management often involves capsulectomy, but prior studies have limitations in scope and methodology.
Purpose of the Study:
- To prospectively identify risk factors associated with capsular contracture.
- To utilize a national database for a comprehensive analysis.
- To improve patient counseling and informed consent processes.
Main Methods:
- Retrospective review of prospectively collected data from the National Surgical Quality Improvement Program (NSQIP) Database (2013-2016).
- Inclusion of patients undergoing periprosthetic and/or total capsulectomy for capsular contracture.
- Multivariable binary logistic regression analysis to calculate odds ratios (OR) and 95% confidence intervals (CI) for identified variables.
Main Results:
- Out of 6547 patients, 2543 (39%) underwent capsulectomy.
- Increased likelihood of capsular contracture was observed in older (OR: 1.10) and overweight (OR: 1.12) patients.
- Cancer patients had a significantly higher risk (OR: 7.71), and wound infection was associated with capsulectomy (OR: 6.69).
Conclusions:
- Identified risk factors for capsular contracture include older age, overweight status, and a history of cancer.
- Wound infection is a significant factor associated with capsulectomy.
- These findings necessitate thorough discussion with patients during the informed consent process prior to breast augmentation or reconstruction procedures.
