Capsular contracture after breast reconstruction with tissue expansion.
Tissue expansion before placement of an implant for breast reconstruction is said to lessen the chance of capsular contracture. Forty-nine patients who had undergone post-mastectomy breast reconstruction using tissue expansion were reviewed. Capsular contracture was assessed using the Baker scale and compared with the speed of expansion, the degree of over-expansion and the interval between full expansion and placement of the definitive prosthesis. The overall incidence of capsular contracture (Baker III or worse) was 29%. Only one patient, however, has required capsulotomy for capsular contracture alone. Neither the speed of expansion nor the degree of over-expansion influenced the onset of contracture. Those patients with breasts assessed in Baker group I had a significantly longer interval between full expansion and reconstruction than those in Baker group III (p = 0.05). A modification of Baker's scale is suggested for the assessment of reconstructed breasts. Prospective studies are required to define the optimum timing for tissue expansion procedures.
Holmes
J D
JD
Plastic Surgery and Burns Research Unit, University of Bradford.
D000328:Adult; D000368:Aged; D001940:Breast / Q000601:surgery*; D003286:Contracture / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D019736:Prostheses and Implants; D012086:Reoperation; D013518:Surgery, Plastic; D015626:Tissue Expansion