Outcome of Mammary Capsulotomies

Moufarrège, Richard; Beauregard, Gilles; Bossé, Jean-Paul; Papillon, Joan; Perras, Colette

doi:10.1097/00000637-198707000-00010

Cited by 47 publications

(24 citation statements)

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“…7-9 In silicone-implant breast augmentation, often the abundant breast soft tissue may allow complete capsule removal without significantly affecting breast shape. In patients with preexisting thin nasal skin, the removal of the capsule can lead to nasal dorsal skin irregularities and significant graft demarcation show.…”

Section: Discussionmentioning

confidence: 99%

Effective Use of a Silicone-induced Capsular Flap in Secondary Asian Rhinoplasty

Jeong¹,

Oh²,

Suh³

et al. 2014

Plastic and Reconstructive Surgery Global Open

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Summary:Performing secondary rhinoplasty in patients who underwent primary rhinoplasty using a silicone implant is difficult due to thinning of nasal skin and formation of a capsule. Excess capsule formation can cause capsular contracture, resulting in short nose deformity or implant deviation, migration, or implant demarcation. Revision rhinoplasty using a capsular flap, dorsal silicone implant, and tip plasty was performed in 95 Korean patients (91 women and 4 men; mean age, 27 years) who previously underwent primary augmentation rhinoplasty using silicone implants. The capsular flap was composed by creating a dual plane above the anterior capsule and below the posterior capsule. The existing silicone implant was removed, and a new silicone implant was placed under the posterior capsule. The patients were followed up for 6 months to 4 years (mean, 31.7 months). Of the 95 patients who underwent secondary augmentation rhinoplasty using a capsular flap, 88 patients (92.6%) showed satisfactory results. There was no hematoma or nasal skin vascular compromise. There was no visible or palpable capsule resorption or recurrent capsular contracture. Early implant malpositioning (within 30 days postoperatively) was observed in 4 patients, and tip shape dissatisfaction (within 60 days postoperatively) was reported by 3 patients. Four patients underwent revision surgery and had successful outcomes. Nasal augmentation using a silicone implant and capsular flap in secondary rhinoplasty avoids complications caused by removal of the capsule. Recurrent capsule formation or clinically noticeable resorption of the capsular flap was not observed in this study.

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Section: Discussionmentioning

confidence: 99%

Effective Use of a Silicone-induced Capsular Flap in Secondary Asian Rhinoplasty

Jeong¹,

Oh²,

Suh³

et al. 2014

Plastic and Reconstructive Surgery Global Open

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“…However, our study assessed soft tissue adhesions, which take longer to develop, so we evaluated the clinical outcome at over 1 year as suggested by Park et al 23 Their experimental study evaluated the effects of a temperature-sensitive poloxamer/alginate mixture used to prevent capsular contracture after silicone implant insertion. The authors defined the proper follow-up time as longer than 6 months postoperatively according to Moufarrege et al 24 One important strength of our study was that we compared two groups through a randomized prospective study with critical inclusion/exclusion criteria. In addition, the patients were followed up and evaluated radiologically by a single orthopedic surgeon who was blind to study protocol.…”

mentioning

confidence: 99%

Effects of a Temperature-sensitive, Anti-adhesive Agent on the Clinical Outcome of Carpal Tunnel Release Surgery

Min

Shin

2018

Arch Hand Microsurg

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Purpose:We investigated the anti-adhesive effects of a temperature-sensitive poloxamer/alginate mixture (Guardix-SG ® ; Hanmi Medicare Inc., Korea) through a prospective randomized controlled study for carpal tunnel release surgery. Methods: The 47 patients who received the infusion were classified as Group 1, and the 51 patients who did not were classified as Group 2. Basic demographic factors and preoperative clinical status were evaluated. At the postoperative 18 months, the degree of clinical recovery and adhesion around the median nerve for both groups were evaluated and compared using sonography. Results:The clinical outcomes, which were assessed using the six-item carpal tunnel symptoms scale, were not significantly different between the groups. However, sonography showed that adhesions around the median nerve were significantly less common in the infusion group. Conclusion: Although the anti-adhesive effects of the temperature-sensitive Guardix-SG® were apparent upon radiological investigation, its use was not associated with a significant difference in clinical outcome on the short-term period follow-up.

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“…However, open capsulotomies are typically regarded as inadequate, and more disposed to recurrence of a capsular contracture. 7 This opinion is based on studies published in the 1970s and 1980s 10–15 evaluating women treated with leaky second-generation silicone gel implants. Although open capsulotomies were commonly performed in the 1980s, 16 this procedure was largely replaced by capsulectomy 17 after investigators implicated bacterial biofilms as a cause of capsular contractures.…”

mentioning

confidence: 99%

“…6,20 This study was undertaken to determine the efficacy of open capsulotomy alone as a treatment for capsular contracture in breast augmentation patients treated with modern, third-generation breast implants, including saline implants, that were not evaluated in early studies. 10–15 This is an important clinical question because saline implants were used almost exclusively in the United States from 1992 to 2006 during the silicone gel moratorium, and continue to be a popular choice among patients, 5 representing approximately 30% of breast augmentation patients in the United States today (Mentor Worldwide LLC, Personal communication, May 2016).…”

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confidence: 99%

Open Capsulotomy: An Effective but Overlooked Treatment for Capsular Contracture after Breast Augmentation

Swanson

2016

Plastic and Reconstructive Surgery - Global Open

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Background:The prevailing theory for capsular contracture after breast augmentation is a subclinical capsular infection. A capsulectomy, site change, and implant replacement are recommended. An open capsulotomy leaves the capsule in the patient. Theoretically, such a procedure would be ineffective because it does not remove the infected tissue. Recurrences occurred frequently in women treated in the 1970s when leaky silicone gel implants were in use. Open capsulotomy has not been studied in women implanted with third-generation devices.Methods:Seventy-five consecutive women with Baker III/IV capsular contractures after breast augmentation treated with open capsulotomies between 1996 and 2016 were retrospectively evaluated. The original implants were usually saline-filled (72.2%). Replacements were all smooth and round, and 92.6% were also saline-filled.Results:Seventeen women (22.7%) developed a recurrent capsular contracture. Two patients (2.7%) experienced a second recurrence. Patients with ruptured silicone gel implants (n = 13) had a significantly greater risk of recurrence (P = 0.01). There was no significant difference in recurrence rates comparing patients whose intact implants were reinserted (12.5%) with women whose intact implants were replaced (18.2%). Povidone–iodine irrigation did not affect the recurrence rate. Capsular contracture was corrected with 1 procedure in 77.3% of patients and 2 procedures in 97.3% of patients.Conclusions:Open capsulotomy is a safe and effective treatment that avoids the additional morbidity and cost of a capsulectomy. The findings challenge the infected biofilm theory of capsular contracture. Open capsulotomy deserves reconsideration by plastic surgeons.

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Outcome of Mammary Capsulotomies

Cited by 47 publications

References 0 publications

Effective Use of a Silicone-induced Capsular Flap in Secondary Asian Rhinoplasty

Effective Use of a Silicone-induced Capsular Flap in Secondary Asian Rhinoplasty

Effects of a Temperature-sensitive, Anti-adhesive Agent on the Clinical Outcome of Carpal Tunnel Release Surgery

Open Capsulotomy: An Effective but Overlooked Treatment for Capsular Contracture after Breast Augmentation

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