Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC- location VUmc, De Boelelaan 1117, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Aesthetic Plast Surg. 2021 Jun;45(3):1328-1337. doi: 10.1007/s00266-021-02141-6. Epub 2021 Feb 8.
Capsular contracture is the leading complication after surgery with breast implants. A lot of progress has been made investigating this complication over the years, and knowledge has been gained on this complication. Currently, the exact cause for capsular contracture is still unclear. It has been hypothesized that immunobiological factors (i.e., immunological and bacterial factors) and several risk factors play a central role in its development. In this paper, we give an overview of the known immunological factors that have been investigated in contracted and non-contracted capsules, as well as the role of bacterial formation around breast implants. We also report on risk factors that might increase the risk of capsular development. Lastly, it provides the latest research on this matter and discusses future perspectives as follow-up research is needed to unravel the pathogenic process leading to capsular contracture. This knowledge is of interest to establish medical therapies in order to prevent such side effects. Overall, capsular contracture seems to be a multifactorial condition consisting of several risk factors. LEVEL OF EVIDENCE V: 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 .
包膜挛缩是乳房植入术后的主要并发症。多年来，人们在研究这种并发症方面取得了很大进展，并对此有了更多的了解。目前，包膜挛缩的确切原因仍不清楚。有假说认为免疫生物学因素（即免疫和细菌因素）和几个风险因素在其发展中起核心作用。本文综述了在挛缩和非挛缩包膜中研究过的已知免疫因素，以及细菌在乳房植入物周围形成的作用。我们还报告了可能增加包膜形成风险的危险因素。最后，它提供了关于这个问题的最新研究，并讨论了未来的观点，因为需要进一步的研究来阐明导致包膜挛缩的发病过程。了解这些知识对于制定预防这种副作用的医疗方法很有意义。总的来说，包膜挛缩似乎是一种多因素的疾病，由几个危险因素组成。证据水平 V：本杂志要求作者为每篇文章分配一个证据水平。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 。
