Review of closed capsulotomy complications

Area of Science:

• Plastic Surgery
• Biomaterials Science

Background:

• Capsular contracture is a common complication following breast augmentation.
• It can lead to undesirable aesthetic outcomes and patient dissatisfaction.

Purpose of the Study:

• To evaluate the efficacy and safety of closed capsulotomy using the nutcracker technique.
• To determine factors influencing the success of capsulotomy.

Main Methods:

• Review of 75 closed capsulotomies performed using the nutcracker technique.
• Tonometric measurements to quantify improvement in breast firmness in 35 cases.
• Grading of capsular contracture and assessment of complications.

Main Results:

• Closed capsulotomy improved breast firmness in most cases, correlating with tonometry.
• Softer results were associated with mild to moderate preexisting capsular contracture and later onset.
• Complications included inability to rupture the capsule, recurrence, and implant rupture in one case.

Conclusions:

• Closed capsulotomy is a viable nonoperative option for mild to moderate capsular contracture.
• It is contraindicated in severe contracture or significant breast distortion.
• The nutcracker technique is recommended, with pressure reduction after capsule tear.