Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, Department of Medical Area (DAME), University of Udine, Udine, Italy.
Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, Montelabbate, Italy.
Aesthetic Plast Surg. 2021 Oct;45(5):2036-2047. doi: 10.1007/s00266-021-02148-z. Epub 2021 Feb 4.
The objective of this clinical review is to provide an overview of the use of breast implants after capsular contracture (CC) surgical treatment, with a focus on type of implants used. Furthermore, our experience in this field is also reviewed.
MEDLINE, EMBASE, Web of Science, Scopus, the Cochrane Central, and Google Scholar databases were reviewed to identify literature related to surgical treatment of capsular contracture and implant replacement. Each article was reviewed by two independent reviewers to ensure all relevant publications were identified. The literature search identified 54 applicable articles. Of these, 26 were found to have a therapeutic level of evidence. The reference lists in each relevant paper were screened manually to include relevant papers not found through the initial search.
Only four articles report the replacement of implants after surgical treatment of capsular contracture. Six articles reported an implant exchange with only smooth silicone gel filled implants. Two reviews advice to use smooth implants in implant replacement.
With our expertise in the field and the results of this up-to-date literature review, it can be concluded that implant exchange is recommended in case of breast revision for capsular contracture, and the use of subpectoral smooth silicone gel breast implants is a good option after surgical treatment in patients with primary or recurrence Baker III-IV.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
本临床综述的目的是概述包膜挛缩（CC）手术后乳房植入物的使用情况，重点介绍所使用的植入物类型。此外，还回顾了我们在这一领域的经验。
通过 MEDLINE、EMBASE、Web of Science、Scopus、Cochrane 中央和 Google Scholar 数据库，检索与包膜挛缩手术治疗和植入物置换相关的文献。由两位独立审稿人对每篇文章进行评估，以确保确定了所有相关出版物。文献检索确定了 54 篇相关文章。其中，有 26 篇被认为具有治疗证据水平。手动筛选每篇相关论文的参考文献列表，以纳入通过初始搜索未找到的相关论文。
只有四篇文章报道了包膜挛缩手术后植入物的更换。六篇文章报道了仅使用光滑硅胶填充植入物的植入物置换。两篇综述建议在包膜挛缩乳房修复时使用光滑植入物。
根据我们在该领域的专业知识和最新文献综述的结果，可以得出结论，在因包膜挛缩而进行乳房翻修时建议进行植入物置换，在初次或复发的 Baker III-IV 患者中，在手术治疗后使用皮下光滑硅胶乳房植入物是一个不错的选择。
证据等级 III：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南 www.springer.com/00266。
