Background: Capsular contracture is common in breast augmentation and reconstruction surgery. The present systematic review discusses the safety of textured and smooth implants in the submuscular position. Methods: A literature search was conducted on PubMed and EMBASE from inception until June 2020. The primary outcome was reduction of capsular contracture (Baker grade); others included time of capsular contracture onset, implant position/rupture rate/surface, hematoma/seroma risk, surgeon assessment and patient satisfaction. A total of 7731 patients were included from six publications. Results: The overall risk rate for capsular contracture increased from 7.6 to 25% in 10 years. The capsular contracture rates in textured and smooth implants were 3-14% and 6-20%, respectively, and no significant difference between implants was observed when the implants were placed submuscularly. Submuscular placement and textured implants also reduced the incidence of other complications. Conclusion: This systematic review suggests that appropriate placement reduces capsular contracture rate, irrespective of implant surface.
Keywords: augmentation; breast; implant; reconstruction; smooth; textured.
Lay abstract Breast reconstruction using breast implants is accompanied by complications that occur following surgery and which can lead to repeated surgeries and, ultimately, patient dissatisfaction. A search of published research was conducted on two major databases, and research published before June 2020 was included in our analysis. The primary outcome was the reduction of capsular contracture, a particular postoperative complication. Six articles (including one randomized controlled trial) were identified, with a total of 7731 patients. The overall risk for developing capsular contracture in breast reconstruction and augmentation patients increased from 7.6 to 25% over a period of 10 years. This systematic review suggests that with appropriate placement of the implant, the rate of capsular contracture and other complications can be reduced in women undergoing surgery, irrespective of implant surface type.