Ultrasound Criteria and Baker Scale for Breast Implant Capsular Contracture Diagnosis

Due to the subjectivity of the Baker scale in grading capsular contracture (CC), an objective and reproducible measurement tool is necessary to estimate the presence and grade of CC in patients with breast implants. This study aimed to assess the capacity of breast ultrasonography to identify CCs using the Baker grading system.

This study included patients who underwent breast augmentation with implants or implant-based breast reconstruction. Patient demographics, surgical type, and ultrasonographic variables were analyzed. The Kruskal-Wallis test was used to determine differences between means, and the Fisher exact test was used for binary variables.

A total of 21 patients (28 breasts) with smooth surface implants were included. In total, 39.2% of breasts had a score of Baker I, 25% had Baker II, 17.9% had Baker III, and 17.9% had Baker IV. When comparing breasts graded Baker I to IV, a mean capsule thickness of 0.6 ± 0.2, 1.0 ± 0.53, 1.68 ± 0.99, and 1.52 ± 0.46 mm, respectively, was shown (P = 0.0044). The breast implant deformity variable was significantly different between Baker grades I to IV (0.0218). Finally, Baker III and IV categories were five times more likely to have abnormal wrinkles than Baker I and II (odds ratio, 5.25; 95% confidence interval, 0.82-33.45; P = 0.0496).

Ultrasound is a useful tool for evaluating the presence of augmented thickness, implant shape deformity, and abnormal wrinkles of the implant shell in correlation with the severity of CC.