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The correction of capsular contracture by conversion to "dual-plane" positioning: technique and outcomes.

作者信息

Spear Scott L, Carter Mary Ella, Ganz Jason C

机构信息

Division of Plastic Surgery, Georgetown University Medical Center, Washington, DC 20007, USA.

出版信息

Plast Reconstr Surg. 2003 Aug;112(2):456-66. doi: 10.1097/01.PRS.0000070987.15303.1A.


DOI:10.1097/01.PRS.0000070987.15303.1A
PMID:12900603
Abstract

Little has been published regarding the treatment of patients with long-established capsular contracture after previous submuscular or subglandular breast augmentation. This study reviews 7 years of experience in treating established capsular contracture after augmentation mammaplasty by relocating implants to the "dual-plane" or partly subpectoral position. A retrospective chart review was performed on all patients who were treated for capsular contracture using this technique between 1993 and 1999. Data collected included the date of the original augmentation, the original implant location, date of revision and type of implant used, length of follow-up, outcome, and any ensuing complications. Different surgical techniques were used, depending on whether the prior implant was located in a subglandular or submuscular plane. All patients had revisions such that their implants were relocated to a dual plane, with the superior two thirds or so of the implant located beneath the pectoralis major muscle and the inferior one third located subglandularly. Of 85 patients reviewed, 54 had their original implants in a submuscular position and 31 had their initial augmentation in a subglandular position. Of the 54 patients whose implants were initially submuscular, 23 patients (43 percent) had silicone gel implants, 15 patients (28 percent) had double-lumen implants, and the remaining 16 patients (30 percent) had saline implants. Of the 31 patients whose implants were initially subglandular, 20 patients (65 percent) had silicone gel implants, three patients (10 percent) had double-lumen implants, and the remaining eight patients (26 percent) had saline implants. Fifty-one patients (60 percent) had replacement with saline implants (37 smooth saline, 14 textured saline), whereas 34 (40 percent) had silicone gel implants (seven smooth gel, 27 textured gel). The average time from previous augmentation to revision was 9 years 9 months. The average follow-up time after conversion to the dual-plane position was 11.5 months. Only three of 85 patients required reoperation for complications, all of which involved some degree of implant malposition. Of patients converted to the dual plane, 98 percent were free of capsular contracture and were Baker class I at follow-up, whereas 2 percent were judged as Baker class II. There were no Baker level III or IV contractures at follow-up. The dual-plane method of breast augmentation has proved to be an effective technique for correcting established capsular contracture after previous augmentation mammaplasty. This technique appears to be effective when performed with either silicone or saline-filled implants.

摘要

相似文献

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引用本文的文献

[1]
Is a Seroma the "Kiss of Death" in Prepectoral Tissue Expander Reconstruction?

Plast Reconstr Surg Glob Open. 2025-6-6

[2]
Implant-based breast surgery and capsular formation: when, how and why?-a narrative review.

Ann Transl Med. 2023-10-25

[3]
Subpectoral Implant Repositioning With Partial Capsule Preservation: Treating the Long-Term Complications of Subglandular Breast Augmentation.

Aesthet Surg J Open Forum. 2021-3-2

[4]
Surgical Treatment of Capsular Contracture (CC): Literature Review and Outcomes Utilizing Implants in Revisionary Surgery.

Aesthetic Plast Surg. 2021-10

[5]
Endoscopic transaxillary prepectoral conversion for submuscular breast implants.

Arch Plast Surg. 2018-3

[6]
Two-Stage Tissue-Expander Breast Reconstruction: A Focus on the Surgical Technique.

Biomed Res Int. 2017-12-10

[7]
Tissue expansion for breast reconstruction: Methods and techniques.

Ann Med Surg (Lond). 2017-7-21

[8]
Current opinions on indications and algorithms for acellular dermal matrix use in primary prosthetic breast reconstruction.

Gland Surg. 2015-6

[9]
Breast augmentation.

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