Risk factors for developing capsular contracture in women after breast implant surgery A systematic review of the literature

Publication date: Available online 9 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Yara Bachour, Claudia A. Bargon, Christel J.M. de Blok, Johannes. C.F Ket, Marco J.P.F Ritt, Frank B. Niessen
BackgroundCapsular contracture is the most frequent complication in breast augmentation or reconstruction with breast implants. The exact mechanism for this complication is not completely understood. Yet, it is most likely to be a multifactorial condition. Several patient-, as well as surgery-, and implant-specific risk factors have been related to cause capsular contracture. This review aims to provide a clear overview of all risk factors for capsular contracture.MethodsA systematic literature review was performed focusing on patient-, surgery- and/or implant-related factors related to capsular contracture in breast implants. PubMed, Embase.com, and Wiley/Cochrane Library databases were searched for relevant articles published from inception up to October 20, 2016. The included studies were assessed for the following main variables: study characteristics, patient characteristics, indication for surgery, type of surgery, implant characteristics, and other characteristics.ResultsData for the risk factors for the development of capsular contracture was retrieved from 40 studies. A presumptive increased risk in the development of capsular contracture for the following variables is shown: longer duration of follow-up, breast reconstructive surgery in patients with a history of breast cancer, subglandular implant placement, post-operative hematoma, and a textured implant surface. There is little, weak or no evidence for the other factors in relation to capsular contracture. This review also shows a large heterogeneity between studies and within the definition of capsular contracture.ConclusionThis review provides an overview of the relationship between patient-, surgery-, and implant-specific risk factors in the development of capsular contracture.