Abstract
A critical comparison of the contracture rate in subglandular versus subpectoral augmentations was done in a personal series (senior author's) of 100 consecutive augmentation patients, 50 with subglandular augmentation and 50 with subpectoral augmentation. The average followup for the series was 27 months. Baker's classification of capsule contracture was utilized. Overall contracture rate in the subglandular group was 58% (29 of 50 patients) while in the subpectoral group it was 22% (11 of 50 patients),p<0.0002. Considering only the more severe contractures (Baker III & IV), the subglandular patients had 48% (24/50) while the subpectoral patients had 14% (7/50),p<0.0002. Comparing the more severe contractures in individual breasts, the subglandular group had 41% and the subpectoral group had 8%,p<0.0001. We conclude that in this personal series of patients, subpectoral placement of the prosthesis has significantly reduced but not eliminated the occurrence of capsule contracture without sacrificing a normal breast appearance.
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References
Baker JL Jr: Augmentation mammoplasty. In Owsley JQ Jr, and Petterson RA, eds), Symposium of Aesthetic Surgery of the Breast. St. Louis: Mosby, 1978 pp 256–263
Cronin TD, Persoff MM, Upton J: Augmentation mammaplasty: Complications and Etiology. In Oswley JQ Jr, and Peterson RA, eds, Symposium of Aesthetic Surgery of the Breast. St. Louis: Mosby, 1978 pp 272–282
Dempsey WC, Latham WD: Subpectoral implants in augmentation mammaplasty. Plast Reconst Surg42:515, 1968
Dubin D: The etiology, pathophysiology, predictability and early detection of spherical scar contracture of the breast. Presented at the 13th Annual Meeting of the American Society for Aesthetic Plastic Surgery, Orlando, FL, 1980.
Gruber RP, Friedman GD: Periareolar subpectoral augmentation mammaplasty. Plast Reconstr Surg67:453, 1981
Hipps CJ, Raju DR, Straith RE: Influence of some operative and postoperative factors on capsular contracture around breast prostheses. Plast Reconstr Surg61:384, 1978
Kelly MJ: Personal communication, 1982
Little G, Baker JL Jr: Results of closed compression capsulotomy for treatment of contracted breast implant capsules. Plast Reconstr Surg65:30, 1980
Mahler D, Hauben DJ: Retromammary versus retropectoral breast augmentation—a comparative study. Ann Plast Surg8:370, 1982
McGrath MH, Burkhardt BR: The safety and efficacy of breast implants for augmentation mammaplasty. Plast Reconstr Surg74:550, 1984
Papillon J: Pros and cons of subpectoral implantation. Clin plast Surg3:321, 1976
Pickrell KL, Puckett CL, Given KS: Subpectoral augmentation mammoplasty. Plast Reconstr Surg60:325, 1977
Ransjo U, Asplund OA, Gylbert L, Jurell G: Bacteria in the female breast. Scand J Plast Reconstr Surg19:87, 1985
Regnault, P: Partially submuscular breast augmentation. Plast Reconstr Surg59:72, 1977
Scully SJ: Augmentation mammaplasty without contracture. Ann Plast Surg6:262, 1981
Shah Z, Lehman JA, Jr, Stevenson G: Capsular contracture around silicone implants: the role of intraluminal antibiotics. Plast Reconstr Surg69:809, 1982
Snyder G: Planning an augmentation mammaplasty. Plast Reconstr Surg54:132, 1974
Truppman ES, Ellenby JD: A 13 year evaluation of subpectoral augmentation mammaplasty. In Owsley JQ Jr, and Peterson RA eds, Symposium of Aesthetic Surgery of the Breast. St. Louis: Mosby, 1978 pp 344–352
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Puckett, C.L., Croll, G.H., Reichel, C.A. et al. A critical look at capsule contracture in subglandular versus subpectoral mammary augmentation. Aesth. Plast. Surg. 11, 23–28 (1987). https://doi.org/10.1007/BF01575478
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DOI: https://doi.org/10.1007/BF01575478