In this month’s issue of Plastic & Reconstructive Surgery, is a study that will be of interest to all who follow breast augmentation. It’s a 5 year analysis of capsular contracture rates using Sientra implants for first-time breast augmentation, and a look at some of the factors that influenced capsule formation in 2560 first-time breast augmentation patients. A variety of surgical methods – subglandular, submuscular, different incisions, and other factors were reviewed.
The investigators found that, in looking at the group as a whole:
– subglandular placement of implants increased the risk of a capsule by 4.6 times
– use of periareolar incisions had more contractures than inframammary incisions by 1.5 times
– Sientra smooth implants had 4.7 times more contractures than Sientra textured implants overall.
These findings have been noted in previous implant studies, so they were not any big surprise to me. They confirm my decisions to switch away from the periareolar incision, and stay with the submuscular dual-plane placement method.
To me, the most interesting part of this article was the grouping of capsule formation rates by technique:
|smooth implant in a subglandular pocket
||21% capsule rate
|smooth implant in a submuscular pocket
||5% capsule rate
|textured implant in a subglandular pocket
||5% capsule rate
|textured implant in a submuscular pocket
||2% capsule rate
Since I currently do my breast augmentation operations with a submuscular pocket, this data suggests that if I were to use Sientra textured implants, I could reduce my capsule rate to 2%, from its current rate of 4% with smooth gel implants. That’s a pretty convincing argument to recommend these implants. Based on 200 augmentations a year, for example, I could potentially prevent 4 women from having issues with capsules each year, just by choosing a different implant. And that, to me, is well worth considering.
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