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Updated: Jan 24, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Capsular Contracture Rates in Subfascial and Subglandular Breast Augmentation With Smooth vs Textured Implants.

Erin N Abbott1, Jordan Johnson1, Nomongo Dorjsuren2

  • 1Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Aesthetic Surgery Journal
|January 23, 2026
PubMed
Summary
This summary is machine-generated.

Subfascial placement does not significantly reduce capsular contracture (CC) rates for smooth breast implants compared to subglandular placement. Previously observed benefits of subfascial augmentation were likely due to textured implants, not the surgical plane itself.

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Area of Science:

  • Plastic Surgery
  • Biomaterials Science
  • Medical Device Research

Background:

  • Capsular contracture (CC) is a complication in breast augmentation.
  • Subfascial placement was historically thought to reduce CC.
  • The shift to smooth implants necessitates re-evaluation of placement techniques.

Purpose of the Study:

  • To compare CC rates between subfascial and subglandular breast augmentation.
  • To stratify analysis by implant surface (smooth vs. textured).
  • To assess the influence of surgical plane on CC in contemporary breast augmentation.

Main Methods:

  • Systematic review and meta-analysis of relevant studies.
  • Searched major databases (PubMed, Embase, Scopus, CENTRAL, Google Scholar) through April 2025.
  • Included studies reporting CC rates for primary augmentation with specified implant surface and plane; employed random-effects models and subgroup analyses.

Main Results:

  • No significant difference in CC rates for smooth implants between subfascial and subglandular placement (7.2% vs 17.1%, p=0.13).
  • Textured implants also showed no significant difference between planes (0.9% vs 3.7%, p=0.08).
  • Recent studies (post-2015) and longer follow-ups (>24 months) confirmed comparable CC rates for smooth implants across planes.

Conclusions:

  • When controlling for implant surface, subfascial and subglandular placement yield similar CC rates in breast augmentation.
  • Observed reductions in CC with subfascial placement in prior studies are attributable to cohorts using textured implants.
  • In current practice with smooth implants, CC rates are consistent across prepectoral planes.