Haas Evan, Christodoulou Neophytos, Secanho Murilo, Kokosis George, Malgor Rafael D, Winocour Julian, Yu Jason W, Mathes David W, Kaoutzanis Christodoulos
Aesthet Surg J Open Forum. 2025 Jan 15;7:ojaf003. doi: 10.1093/asjof/ojaf003. eCollection 2025.
Capsular contracture is characterized by the formation of a fibrous capsule around a breast implant after an augmentation mammaplasty, and often results in pain, firmness, and implant distortion. The aim of this meta-analysis was to investigate how implant and surgical characteristics affect rates of capsular contracture after breast augmentation. A systematic review and meta-analysis were performed in PubMed MEDLINE, EMBASE (OvidSP), and Cochrane Library. Comparison groups included smooth vs textured implants; subpectoral vs prepectoral implant placement; saline vs silicone implants. Odds ratios (ORs) were calculated for capsular contracture for each of these groups. The inclusion criteria were met in 24 studies. Smooth implants were associated with significantly higher capsular contracture rates compared with textured implants (OR = 2.80, 95% CI, 1.92-4.08). Subpectoral implant placement demonstrated significantly reduced capsular contracture rates compared with prepectoral placement (OR = 0.35, 95% CI, 0.25-0.50). No significant difference in capsular contracture rates was found between silicone and saline (OR = 0.39, 95% CI, 0.02-6.69). This meta-analysis suggests that textured-surface implants are associated with lower capsular contracture rates than smooth implants following breast augmentation. Additionally, subpectoral implant placement was associated with significantly reduced rates of capsular contracture compared with prepectoral placement. There was no significant difference in capsular contracture rates between saline and silicone implants. However, the absence of large, randomized controlled trials included in this study underscores the need for prospective investigation of the relationship between implant and surgical characteristics and postoperative outcomes.
包膜挛缩的特征是在隆乳术后乳房植入物周围形成纤维包膜，常导致疼痛、变硬和植入物变形。本荟萃分析的目的是研究植入物和手术特征如何影响隆胸术后包膜挛缩的发生率。在PubMed MEDLINE、EMBASE（OvidSP）和Cochrane图书馆进行了系统评价和荟萃分析。比较组包括光面与毛面植入物；胸大肌下与胸大肌前植入物放置；盐水与硅胶植入物。计算了这些组中每组包膜挛缩的比值比（OR）。24项研究符合纳入标准。与毛面植入物相比，光面植入物的包膜挛缩率显著更高（OR = 2.80，95%CI，1.92 - 4.08）。与胸大肌前放置相比，胸大肌下植入物放置的包膜挛缩率显著降低（OR = 0.35，95%CI，0.25 - 0.50）。硅胶和盐水之间的包膜挛缩率未发现显著差异（OR = 0.39，95%CI，0.02 - 6.69）。本荟萃分析表明，隆胸术后毛面植入物的包膜挛缩率低于光面植入物。此外，与胸大肌前放置相比，胸大肌下植入物放置的包膜挛缩率显著降低。盐水和硅胶植入物之间的包膜挛缩率没有显著差异。然而，本研究中缺乏大型随机对照试验强调了对植入物和手术特征与术后结果之间关系进行前瞻性研究的必要性。
