Nonsurgical treatment of capsular contracture: Review of clinical studies

Papaconstantinou, Anthony; Κoletsa, Triantafyllia; Demiri, Efterpi; Gasteratos, Kostantinos; Tzorakoleftheraki, Sofia-Eleni; Pavlidis, Leonidas; Spyropoulou, Georgia‐Alexandra

doi:10.1177/0300060520927873

Cited by 9 publications

(5 citation statements)

References 28 publications

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“…Post-implantation tissue fibrosis is associated with a variety of factors, ranging from the type of prosthetic material used, bacterial infection, inflammatory response-mediated factors, and even surgical incision [ 8 ]. To date, several studies have sought to develop strategies to prevent and treat capsular contracture, including surgery, acellular dermal matrix [ 7 , 34 ], fat grafting [ 35 ], and medication [ 36 , 37 ]. In this study, we focused on cell therapy and investigated the role of ASCs in the process of capsular formation in a mouse model.…”

Section: Discussionmentioning

confidence: 99%

Implantation and tracing of green fluorescent protein-expressing adipose-derived stem cells in peri-implant capsular fibrosis

Park

Kwon

et al. 2023

Stem Cell Res Ther

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Background Adipose-derived stem cells (ASCs) have been reported to reduce fibrosis in various tissues. In this study, we investigated the inhibitory role of ASCs on capsule formation by analyzing the histologic, cellular, and molecular changes in a mouse model of peri-implant fibrosis. We also investigated the fate and distribution of ASCs in the peri-implant capsule. Methods To establish a peri-implant fibrosis model, customized silicone implants were inserted into the dorsal site of C57BL/6 wild-type mice. ASCs were harvested from the fat tissues of transgenic mice that express a green fluorescent protein (GFP-ASCs) and then injected into the peri-implant space of recipient mice. The peri-implant tissues were harvested from postoperative week 2 to 8. We measured the capsule thickness, distribution, and differentiation of GFP-ASCs, as well as the cellular and molecular changes in capsular tissue following ASC treatment. Results Injected GFP-ASCs were distributed within the peri-implant capsule and proliferated. Administration of ASCs reduced the capsule thickness, decreased the number of myofibroblasts and macrophages in the capsule, and decreased the mRNA level of fibrogenic genes within the peri-implant tissue. Angiogenesis was enhanced due to trans-differentiation of ASCs into vascular endothelial cells, and tissue hypoxia was relieved upon ASC treatment. Conclusions We uncovered that implanted ASCs inhibit capsule formation around the implant by characterizing a series of biological alterations upon ASC treatment and the fate of injected ASCs. These findings highlight the value of ASCs for future clinical applications in the prevention of capsular contracture after implant-based reconstruction surgery.

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Section: Discussionmentioning

confidence: 99%

Implantation and tracing of green fluorescent protein-expressing adipose-derived stem cells in peri-implant capsular fibrosis

Park

Kwon

et al. 2023

Stem Cell Res Ther

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“…Compared to surgical treatment, nonsurgical methods significantly decrease overall costs by avoiding facility fees, anesthesia costs, and surgeon rates. Popular nonsurgical treatments for capsular contracture include intracapsular injection of triamcinolone, ultrasonic applications, oral Zafirlukast, Flector patch, and laser treatments [ 9 ]. While treatment of capsular contracture proved to be successful in most patients, the additional financial burden added to the original cost of the breast surgery can be challenging in addition to patient compliance with the treatment plan.…”

Section: Discussionmentioning

confidence: 99%

Non-surgical Treatment of Capsular Contracture by Overfilling a Spectrum™ Saline Implant

Braud,

Yerke Hansen,

Sadeh

et al. 2023

Cureus

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Capsular contracture is one of the most common complications following breast implant use in both aesthetic and reconstructive surgery procedures. Furthermore, capsular contracture remains one of the most common causes of reoperation in these patients. Therefore, it is important to identify and explore new treatment options to alleviate the risks associated with surgery as well as the financial burden of reoperation. We present a case of successful nonsurgical treatment of capsular contracture by overfilling a Spectrum™ adjustable saline implant followed by volume reduction. A 53-year-old patient was examined in our clinic post bilateral mastectomy and immediate reconstruction adjustable Spectrum™ saline implants in the subglandular plane. Two years postoperatively, the patient presented with Grade III capsular contracture in her right breast. Treatment was administered by overfilling the 275cc implant with 250cc in the right breast to rupture the capsule. The implant was kept overexpanded for a total of 14 days. The volume was subsequently reduced with optimal patient satisfaction. The patient has not had a reoccurrence of capsular contracture in one year. The treatment of capsular contracture by overfilling and temporarily overexpanding a Spectrum™ adjustable saline is a promising technique that warrants further investigation.

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“…Both OIPBR and THIPBR patients showed a non-significant increase in breast satisfaction after surgery compared to the preoperative period but patients in both groups developed capsular contracture at a higher rate than any other complication. Capsular contracture can lead to tenderness and altered shape of the reconstructed breast, as well as to numbness [ 29 ] and poor sexual experience leading to low sexual well-being scores [ 30 ]. Therefore, we also advocate support, help and understanding from partners of IPBR patients to optimize the sexual outcome after IPBR.…”

Section: Discussionmentioning

confidence: 99%

Immediate Prosthesis Breast Reconstruction: A Comparison Between Ambulatory Surgery Versus Traditional Hospitalization Based on the Propensity Score Matching Method

Chen

Liu

et al. 2022

Aesth Plast Surg

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Background The positive benefits of immediate prosthesis breast reconstruction (IPBR) are incontrovertible. During the COVID-19 pandemic, health care resources became scarce. The implementation of outpatient immediate prosthesis breast reconstruction (OIPBR) can improve the efficiency of medical care and reduce viral exposure. Very few studies have focused on OIPBR and this study aimed to fill this gap by evaluating outcomes of OIPBR compared with traditional hospitalization IPBR (THIPBR) in terms of complications and quality of life. Material and Methods The study enrolled patients undergoing IPBR at Tianjin Medical University Cancer Institute and Hospital between January 1, 2020, and September 30, 2021. Outcomes were defined as postoperative complications and quality of life before reconstruction and at 3-month follow-up. Quality of life was assessed by BREAST-Q questionnaire. Inverse probability of treatment weighting and propensity score matching (PSM) were applied to adjust for confounders. Results A total of 135 patients were enrolled, including 110 with THIPBR and 25 with OIPBR. After matching, baseline characteristics were well balanced. Patients with OIPBR had lower rates of lymphedema on the surgery side (p = 0.041) and readmission (p = 0.040) than patients with THIPBR. No statistically significant differences in the quality of life metrics of psychosocial well-being, sexual well-being, satisfaction with breast and physical well-being of the chest were found between the two groups. Conclusion OIPBR is a safe and efficient alternative to THIBPR during the COVID-19 pandemic. It is recommended when medical conditions allow to conserve medical resources. Accelerated technical training for the performance of OIPBR at the hospital level should be expedited. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Nonsurgical treatment of capsular contracture: Review of clinical studies

Abstract: Capsular contracture is one of the most distressing complications of breast implant use in both aesthetic and reconstructive plastic surgery procedures. This systematic review was performed to assess the effectiveness of all nonsurgical treatments for established capsular contracture.

Cited by 9 publications

References 28 publications

Implantation and tracing of green fluorescent protein-expressing adipose-derived stem cells in peri-implant capsular fibrosis

Implantation and tracing of green fluorescent protein-expressing adipose-derived stem cells in peri-implant capsular fibrosis

Non-surgical Treatment of Capsular Contracture by Overfilling a Spectrum™ Saline Implant

Immediate Prosthesis Breast Reconstruction: A Comparison Between Ambulatory Surgery Versus Traditional Hospitalization Based on the Propensity Score Matching Method

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