Oh Won Seok, Lee Seung Hoon, Lee Jae Woo, Seo Jung Yeol, Kim Choong Rak, Nam Su Bong
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea (the Republic of).
Department of Statistics, Pusan National University, Busan, Korea (the Republic of).
Arch Plast Surg. 2025 Jul 23;52(4):217-224. doi: 10.1055/a-2620-3350. eCollection 2025 Jul.
Capsular contracture is a common complication following implant-based breast reconstruction. Current assessment methods, primarily relying on the subjective Baker grading system, lack objectivity and quantitative data, which hinders large-scale studies and the development of treatment guidelines. To solve these problems, we conducted a study using computed tomography (CT) scans to quantitatively evaluate morphological changes in breast implants associated with capsular contracture.
We enrolled 94 patients who underwent breast reconstruction using implants and underwent periodic chest CT scans. We categorized them into two groups: Baker grade I or II ( = 72) and Baker grade III or IV ( = 22). We analyzed the CT scans to assess changes in the implant base and projection.
In the Baker grade III or IV groups, it was confirmed that the ratio of projection to base increased after capsular contracture compared with before contracture. On the other hand, there was no significant change in the ratio of projection to base in the Baker grade I or II groups.
This study highlights the potential of CT scans as a reproducible method for evaluating capsular contracture. The ratio of projection to base could serve as a new quantitative index alongside the Baker grades for clinical assessment, treatment planning, and research on capsular contracture. When comparing the ratio of projection to base before and after capsular contracture, if the ratio of projection to base increases by more than 1.233 times, it can be considered Baker grade III or IV.
包膜挛缩是基于植入物的乳房重建术后常见的并发症。目前的评估方法主要依赖主观的贝克分级系统，缺乏客观性和定量数据，这阻碍了大规模研究以及治疗指南的制定。为了解决这些问题，我们开展了一项利用计算机断层扫描（CT）来定量评估与包膜挛缩相关的乳房植入物形态变化的研究。
我们纳入了94例行植入物乳房重建并接受定期胸部CT扫描的患者。我们将他们分为两组：贝克I级或II级（n = 72）和贝克III级或IV级（n = 22）。我们分析CT扫描结果以评估植入物底部和突出度的变化。
在贝克III级或IV级组中，证实包膜挛缩后突出度与底部的比值相较于挛缩前增加。另一方面，贝克I级或II级组中突出度与底部的比值无显著变化。
本研究凸显了CT扫描作为评估包膜挛缩的可重复方法的潜力。突出度与底部的比值可作为除贝克分级之外用于临床评估、治疗规划和包膜挛缩研究的新定量指标。在比较包膜挛缩前后突出度与底部的比值时，若突出度与底部的比值增加超过1.233倍，则可考虑为贝克III级或IV级。
