Capsular contracture and steroid-related complications in augmentation mammoplasty

Abstract

An analysis of the data obtained in 91 of 161 patients (57%) who had undergone augmentation mammoplasty between 1973 and 1978 demonstrates that corticosteroids should be used with caution and that more data are needed before their efficacy is assured. Moreover, the authors believe that a better understanding of the breast contracture mechanism and specific pharmacologic agents is necessary in order to control the process of capsular contracture.

Chemically Assisted Capsulectomy in the Rabbit Model: A New Approach; Nadeem Ajmal, M.D., Colin L. Riordan, M.D., Nancy Cardwell, B.S., Lillian B. Nanney, Ph.D., and R. Bruce Shack, M.D.

“…When steroids worked at all they worked exceptionally well indeed, producing ptosis, delayed atrophy, severe rippling, and eventual extrusion. [4][5][6][7] Few of us who have shared this experience would risk repeating it! Subacute bacterial infection from the ductal system of the breast remains the most likely suspect as the cause of contracture, and experimental studies failing to address this particular variable may not prove to be clinically applicable.…”

“…Compression exercises are probably ineffective, preoperative systemic antibiotics have been proven ineffective, 9 and steroids can be either completely ineffective or disastrously effective, depending on your choice of dosage and delivery system. [4][5][6][7] Submuscular implant placement remains by far the most effective way to avoid contracture, but it gives poor results in breast ptosis unless accompanied by a mastopexy. My personal results from combining these procedures have often been less than admirable.…”