Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지

The Management of Capsular Contracture: Conversion to "Dual-Plane" Positioning through a Periareolar Approach

구형구축의 치료: 유륜절개 이중평면 전환술

  • Received : 2007.10.08
  • Published : 2008.01.10
⟨ Previous Next ⟩

Abstract

Purpose: The capsular contracture has been the most common complication of augmentation with breast implant, a side effect quite difficult to treat. The latest trends in the correction of capsular contracture include total capsulectomy or conversion of implant pocket. In this study, in an attempt to correct capsular contracture, the authors performed reoperation which involved capsulectomy through peri-areolar approach and dual-plane conversion. The authors hereby report the clinical results of such correction of capsular contracture and examine the efficacy. Methods: The authors selected 46 patients who were admitted to the clinic from January 2004 to January 2007 (37 months), and performed dual-plane conversion through solely peri-areolar approach. Two types of operation were done: dual-plane conversion from subglandular plane or from submuscular plane. Results: The average follow-up time after conversion to the dual-plane position was 10 months. During the follow-up period, 83.1% of patients recovered from capsular contracture and were Baker class I, and in 10.9% the condition had relapsed into Baker class II or III contracture. Conclusion: This study has proven the effectiveness of the dual-plane conversion operation for correcting established capsular contracture after previous augmentation mammaplasty. In this study, all cases of dual-plane conversion operation was performed through peri-areolar approach, which can prevent the occurrence of visible scar on inframammary fold.

Keywords

References

  1. Henriksen TF, Fyzek JP, Hölmich LR, McLaughlin JK, Kjoller K, Hoyer AP, Olsen JH, Friis S: Surgical intervention and capsular contracture after breast augmentation: a prospective study of risk factors. Ann Plast Surg 54: 343, 2005 https://doi.org/10.1097/01.sap.0000151459.07978.fa
  2. Kjoller K, Hölmich LR, Jacobsen PH, Friis S, Fyzek J, McLaughlin JK, Lipworth L, Henriksen TF, Jorgensen S, Bittmann S, Olsen JH: Capsular contracture after cosmetic breast implant surgery in Denmark. Ann Plast Surg 47: 359, 2001 https://doi.org/10.1097/00000637-200110000-00001
  3. Gabriel SE, Woods JE, O'Fallon WM, Beard CM, Kurland LT, Melton LJ 3rd: Complications leading to surgery after breast implantation. N Engl J Med 336: 677, 1997 https://doi.org/10.1056/NEJM199703063361001
  4. Cunningham BL, Lokeb A, Gutowski KA: Saline-filled breast implant safety and efficacy: a multicenter retrospective review. Plast Reconstr Surg 105: 2143, 2000 https://doi.org/10.1097/00006534-200005000-00037
  5. Pajkos A, Deva AK, Vickery K, Cope C, Chang L, Cossart YE: Detection of subclinical infection in significant breast implant capsules. Plast Reconstr Surg 111: 1605, 2003 https://doi.org/10.1097/01.PRS.0000054768.14922.44
  6. Becker H, Springer R: Prevention of capsular contracture. Plast Reconstr Surg 103: 1766, 1999 https://doi.org/10.1097/00006534-199905060-00036
  7. Spear SL, Elmaraghy M, Hess C: Textured-surface saline-filled silicone breast implants for augmentation mammaplasty. Plast Reconstr Surg 105: 1542, 2000 https://doi.org/10.1097/00006534-200004040-00047
  8. Adams WP Jr, Rios JL, Smith SJ: Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six-year prospective clinical study. Plast Reconstr Surg 117: 30, 2006
  9. Fryzek JP, Signorello LB, Hakelius L, Lipworth L, McLaughlin JK, Bolt WJ, Nyren O: Local complications and subsequent symptom reporting among women with cosmetic breast implants. Plast Reconstr Surg 107: 214, 2001 https://doi.org/10.1097/00006534-200101000-00035
  10. Young VL: Guideline and indications for breast implant capsulectomy. Plast Reconstr Surg 102: 884, 1998 https://doi.org/10.1097/00006534-199809030-00043
  11. Collis N, Sharpe DT: Recurrence of subglandular breast implant capsular contracture: anterior versus total capsulectomy. Plast Reconstr Surg 106: 792, 2000 https://doi.org/10.1097/00006534-200009040-00006
  12. Spear SL, Carter ME, Ganz JC: The correction of capsular contracture by conversion to "dual-plane" positioning: technique and outcomes. Plast Reconstr Surg 112: 456, 2003 https://doi.org/10.1097/01.PRS.0000070987.15303.1A
  13. Handel N, Cordray T, Gutierrez J, Jensen JA: A long- term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg 117: 757, 2006 https://doi.org/10.1097/01.prs.0000201457.00772.1d
  14. Tebbetts JB: Axillary endoscopic breast augmentation: processes derived from a 28-year experience to optimize outcomes. Plast Reconstr Surg 118: 53S, 2006 https://doi.org/10.1097/00006534-200609151-00064
  15. Sim HB, Yoon SY: Periareolar dual plane augmentation mammaplasty. J Korean Soc Plast Reconstr Surg 33: 155, 2006