Breast implant capsule flaps and grafts: a review of the literature.
BACKGROUND
A breast implant capsule forms as a physiological response to the foreign material. Over the past decades, authors started to consider the breast implant capsule as a new source of tissue, thus describing several capsular flaps and grafts. The aim of this article is to provide an overview of the applications and indications for the use of capsular tissue flaps and grafts in reconstructive and aesthetic surgery.


METHODS
A review of the literature on breast implant capsule grafts and flaps was conducted. The reported surgical techniques were described and compared for indications and complications. The studies were evaluated and compared for number of patients and follow-up.


RESULTS
The search yielded a total of 21 citations. Patient population was reported in 11 studies for capsular flaps and 2 articles for capsular grafts. Between 1997 and 2012, a total of 74 patients underwent surgery with the use of capsular tissue. Among these, 60 patients had a capsular flap (81 %) and 14 (19 %) had a capsular graft. Complications were experienced in 5 patients (6.7 %).


CONCLUSIONS
Capsular flaps and grafts are indicated mainly to address breast implant-related problems. The breast implant capsule represents a versatile and reliable source of tissue for both aesthetic and reconstructive surgery.


METHODS
This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, 00128, Rome, Italy.
Paolo
P
Persichetti
Francesco
F
Segreto
Alfonso Luca
AL
Pendolino
Romualdo
R
Del Buono
Giovanni Francesco
GF
Marangi
D000818:Animals; D019928:Breast Implantation / Q000009:adverse effects; D018427:Breast Implants / Q000009:adverse effects; D003286:Contracture / Q000601:surgery; D005549:Foreign-Body Reaction / Q000601:surgery; D058752:Free Tissue Flaps; D006801:Humans; D016462:Mammaplasty