Does Implant Surface Texture Affect the Risk of Capsular Contracture in Subglandular Breast Augmentation and Breast Augmentation-Mastopexy?

BACKGROUND Previous studies have reported decreased rates of capsular contracture associated with the use of textured surface breast implants placed in the subglandular plane during breast augmentation. However, since the publication of these studies, our understanding of the pathophysiology of capsular contracture, as well as the surgical techniques utilized to minimize bacterial contamination of the implant, have advanced considerably. OBJECTIVE The purpose of this study was to reevaluate the relationship between implant surface texturization and capsular contracture rates for breast implants placed in the subglandular plane during primary breast augmentation. METHODS Retrospective chart review was performed of all primary subglandular breast augmentation procedures performed using either smooth or textured round silicone gel implants, with or without simultaneous mastopexy. The primary outcome measures included clinically significant capsular contracture (Baker Grade III/IV) and revision surgery for capsular contracture. RESULTS Between 2010 to 2017, 526 patients underwent primary subglandular breast augmentation with either smooth (n=212) or textured (n=314) round silicone gel implants. 248 patients underwent breast augmentation while 278 underwent breast augmentation-mastopexy. Average follow-up was 756 days in the textured group and 461 days in the smooth group. Five cases of capsular contracture were observed in the textured group, and seven cases of capsular contracture were observed in the smooth group (p=0.20). CONCLUSIONS Smooth surface implants placed in the subglandular plane were not at a significantly increased risk of capsular contracture compared to textured surface implants. We suggest that adherence to a surgical technique focused on minimizing bacterial contamination of the implant is of greater clinical significance than implant surface characteristics when discussing capsular contracture.

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