M Bradley Calobrace1,2, W Grant Stevens1,2, Peter J Capizzi1,2, Robert Cohen1,2, Tess Godinez1,2, Maggi Beckstrand1,2. 1. Louisville and Lexington, KY; Marina Del Ray, CA; Charlotte, NC; Santa Monica, CA; and Santa Barbara, CA. 2. From the Division of Plastic Surgery, University of Louisville, and Division of Plastic Surgery, University of Kentucky; Division of Plastic Surgery, University of Southern California School of Medicine, University of Southern California; Department of Plastic Surgery, Presbyterian Hospitals; private practice; Clinical Operations and Medical Affairs, Sientra, Inc.; and MB Statistical Consulting.
Abstract
BACKGROUND: Despite the increased understanding of surgical best practices, capsular contracture remains the most commonly reported complication and reason for reoperation following breast implant surgery. This study provides a long-term update to a previous investigation of potential contributing risk factors for capsular contracture in primary augmentation patients. METHODS: The data used for this analysis include 5,122 implants in 2,565 primary augmentation patients implanted by 34 surgeons based on long-term results from Sientra's clinical study. Potential risk factors, including patient and implant attributes, surgery characteristics, pocket irrigation, and postsurgery characteristics, were analyzed using frequency and multivariate models. RESULTS: A total of 333 capsular contracture events in 224 patients were reported. The overall Kaplan-Meier rate for capsular contracture was 10.8% by device through 10 years. Results from the multivariate analysis found 8 factors to be independently associated with capsular contracture (implant placement, implant surface, incision site, hematoma or seroma development, device size, surgical bra, steroid, and antibiotic pocket irrigation; all P values < 0.05). Results from correlation analysis found 2 of the 8 factors to be more strongly associated with early onset capsular contracture events, compared with those occurring after 2 and 5 years of implantation (implant surface and steroid pocket irrigation). CONCLUSION: The results of this large-scale, multivariate analysis identified several significant risk factors for capsular contracture, including device features (smooth surface, smaller size), surgical factors (periareolar incision, subglandular placement, antibiotic irrigation), the development of hematoma/seroma, and the use of a surgical bra.
BACKGROUND: Despite the increased understanding of surgical best practices, capsular contracture remains the most commonly reported complication and reason for reoperation following breast implant surgery. This study provides a long-term update to a previous investigation of potential contributing risk factors for capsular contracture in primary augmentation patients. METHODS: The data used for this analysis include 5,122 implants in 2,565 primary augmentation patients implanted by 34 surgeons based on long-term results from Sientra's clinical study. Potential risk factors, including patient and implant attributes, surgery characteristics, pocket irrigation, and postsurgery characteristics, were analyzed using frequency and multivariate models. RESULTS: A total of 333 capsular contracture events in 224 patients were reported. The overall Kaplan-Meier rate for capsular contracture was 10.8% by device through 10 years. Results from the multivariate analysis found 8 factors to be independently associated with capsular contracture (implant placement, implant surface, incision site, hematoma or seroma development, device size, surgical bra, steroid, and antibiotic pocket irrigation; all P values < 0.05). Results from correlation analysis found 2 of the 8 factors to be more strongly associated with early onset capsular contracture events, compared with those occurring after 2 and 5 years of implantation (implant surface and steroid pocket irrigation). CONCLUSION: The results of this large-scale, multivariate analysis identified several significant risk factors for capsular contracture, including device features (smooth surface, smaller size), surgical factors (periareolar incision, subglandular placement, antibiotic irrigation), the development of hematoma/seroma, and the use of a surgical bra.
Authors: Shafreena Kühn; Mara Anna Georgijewitsch; Andrej Wehle; Moritz Billner; Lara Küenzlen; Jens Rothenberger; Ulrich Michael Rieger Journal: Breast Care (Basel) Date: 2020-10-16 Impact factor: 2.268
Authors: Joshua Vorstenbosch; Colleen M McCarthy; Meghana G Shamsunder; Thais O Polanco; Stefan Dabic; Itay Wiser; Evan Matros; Joseph Dayan; Joseph J Disa; Andrea L Pusic; Michele R Cavalli; Elizabeth Encarnacion; Meghan Lee; Babak J Mehrara; Jonas A Nelson Journal: Plast Reconstr Surg Date: 2021-11-01 Impact factor: 5.169
Authors: David A Daar; Jonathan M Bekisz; Michael V Chiodo; Evellyn M DeMitchell-Rodriguez; Pierre B Saadeh Journal: Aesthetic Plast Surg Date: 2021-04-16 Impact factor: 2.326
Authors: Mathew T Epps; Sarah Langsdon; Taylor K Pels; Tara M Lee; Todd Thurston; Mark A Brzezienski Journal: Plast Reconstr Surg Glob Open Date: 2019-08-08