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Analysis of Capsular Contracture Among Patients Undergoing Implant Salvage Procedures
Mehak Chawla, MBA; Minh Nguyen, MD; Sunday Okechukwu Edwin Ojiako, MD; Abdulaziz Elemosho, MD; David Nash, MD; Jenny Barker, MD, PhD
The Ohio State University College of Medicine
2024-01-31
Presenter: Mehak Chawla
Affidavit:
I approve this submission.
Director Name: Gregory Pearson
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction: Capsular contracture is a long-term complication following breast implant surgery that can cause pain and deformity. Implant salvage is a management strategy using maneuvers to save an implant-based reconstruction after complications, such as infection. This study sought to identify long-term sequelae of implant salvage procedures, including capsular contracture.
Methods: A retrospective review identified 367 patients with breast cancer who underwent a tissue expander-implant exchange from April 2013 to January 2017. Demographic data such as age, BMI, and smoking status were collected. Perioperative occurrences such as radiation, implant rupture, and treatments for implant infection, such as antibiotics and operative debridement were also collected.
Results: 367 patients with 539 reconstructed breasts were reviewed. The average age was 51.7. The average follow-up was 3.05 years. 9.09% (49 of 539) reconstructed breasts had implant salvage treatments. 38.7% (19 of 49) of those were surgical debridement and implant replacement. 18.2% of the reconstructed breasts developed capsular contracture, with a higher risk among radiated breasts (RR 2.14, 95%CI 1.31-3.49, p=0.002). 28.5% of reconstructed breasts with implant salvage treatments developed capsular contracture. Implant salvage treatments were not a significant risk factor for capsular contracture (RR 1.53, 95%CI 0.77-3.00, p=0.227). Among patients with at least 1-year follow-up, 24.7% of the reconstructed breasts have capsular contracture. A similar rate was found in patients with at least 3 years of follow-up. 28.2% of the capsular contracture at 1 year follow-up were grades 3 and 4.
Conclusions: Implant salvage procedures were not associated with an increased risk of capsular contracture.
