Evaluation of Antibiotic-Impregnated Mesh in Preventing the Recurrence of Capsular Contracture

Systematic Review of Capsular Contracture Management following Breast Augmentation: An Update

BACKGROUND

Capsular contracture is one of the most frequent indications for revision following breast augmentation. Management goals focus on restoring breast aesthetics and minimizing subsequent recurrence of capsular contracture. As new data emerge, close review of the data are merited to build evidence-based clinical guidelines to inform surgical practice and management of capsular contracture.

METHODS

A systematic review of the MEDLINE, Embase, and Cochrane Database of Systematic Reviews databases was conducted to characterize the surgical management of capsular contracture in revision breast augmentations. The primary endpoint was capsular contracture recurrence rate.

RESULTS

The review was conducted in November of 2021. Primary search revealed 14,163 results. Initial screening by title left 1223 articles. Abstract review left 90 articles for full-text review, of which 34 were ultimately included and were all observational in nature.

CONCLUSIONS

Capsular contracture management remains an important topic, with limited high-level evidence for establishing clear evidence-based treatment guidelines. Although more evidence is required to assess the effects of capsulectomy, implant exchange, and plane change, these appear to be useful mechanisms for reducing recurrent capsular contracture. There is more evidence regarding the use of acellular dermal matrix, although this still requires long-term follow-up studies. New developments regarding textured implants limit the revision breast augmentation surgeon to smooth devices.

Advances in Biomaterials for Breast Reconstruction

Breast cancer is one of the most commonly diagnosed malignancies in women. Along with increasing demands for breast reconstruction, the attention given to the psychological and aesthetic benefits of breast reconstruction has also increased. As breast reconstruction and augmentation demands increase, biomaterials for breast reconstruction are being developed, and the related industry is growing quickly worldwide. Among the various biomaterials used for breast enlargement, breast implants have undergone a remarkable evolution since the 1960s. Despite unsatisfactory results and unexpected complications, research dedicated to achieving an ideal breast implant has progressed. In accordance with attention to tissue engineering, a three-dimensional (3D) bioprinting technique for breast tissue regeneration has emerged to overcome the current limitations of breast biomaterials. Along with solid implants, injectable liquid-type fillers are also part of ongoing studies.