Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA.
Aesthet Surg J. 2013 May;33(4):516-21. doi: 10.1177/1090820X13484465.
The safety of augmentation mammaplasty has increased dramatically in the past 20 years. Capsular contracture (CC) is the most commonly reported complication of augmentation mammaplasty.
The authors report the incidence of CC in a low-risk patient population after primary augmentation.
The authors retrospectively reviewed the charts of 856 consecutive patients who underwent primary augmentation mammaplasty between 1999 and 2009. This series did not include patients who underwent breast augmentation-mastopexy, secondary augmentation, revision, and/or reconstruction. Data points included demographics, functional and aesthetic outcomes, complications, and revision rate/type.
The overall incidence of CC in 856 patients was 2.8%. Average follow-up time was 14.9 months. Antibiotic irrigation decreased CC rates from 3.9% to 0.4% (P = .004). Tobacco users had higher rates of contracture than nonsmokers (5.5% vs 1.9%; P = .036). Saline implants had a higher CC rate than silicone gel (4.3% vs 1.3%; P = .032). Using multivariate logistic regression, CC was 7.89 times more likely in saline implants than in silicone gel (P = .027, 95% confidence interval, 1.26-49.00).
Based on our findings, it is apparent that the early CC rate in primary augmentation can be less than 1%. To avoid CC, we advocate an inframmamary approach, submuscular implant placement, and antibiotic irrigation of the breast pocket.
在过去的 20 年中，隆胸术的安全性有了显著提高。包膜挛缩（CC）是隆胸术最常见的并发症。
作者报告了一组低风险患者中初次隆胸后的 CC 发生率。
作者回顾性分析了 1999 年至 2009 年间接受初次隆胸的 856 例连续患者的病历。该系列不包括接受乳房隆乳-乳房悬吊术、二次隆胸、修复术和/或重建术的患者。数据点包括人口统计学、功能和美学结果、并发症以及修复率/类型。
856 例患者中 CC 的总发生率为 2.8%。平均随访时间为 14.9 个月。抗生素冲洗使 CC 发生率从 3.9%降至 0.4%（P =.004）。吸烟者的挛缩发生率高于非吸烟者（5.5%比 1.9%；P =.036）。盐水假体的 CC 发生率高于硅胶凝胶（4.3%比 1.3%；P =.032）。使用多变量逻辑回归，盐水假体发生 CC 的可能性是硅胶凝胶的 7.89 倍（P =.027，95%置信区间，1.26-49.00）。
根据我们的发现，初次隆胸的早期 CC 率可能低于 1%。为了避免 CC，我们提倡采用经乳晕入路、胸肌下植入物放置和乳房袋抗生素冲洗。
3 级。
