Capsular contracture

Revision as of 14:35, 15 May 2009 by Brian Blank (talk | contribs)
Jump to navigation Jump to search

WikiDoc Resources for Capsular contracture

Articles

Most recent articles on Capsular contracture

Most cited articles on Capsular contracture

Review articles on Capsular contracture

Articles on Capsular contracture in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Capsular contracture

Images of Capsular contracture

Photos of Capsular contracture

Podcasts & MP3s on Capsular contracture

Videos on Capsular contracture

Evidence Based Medicine

Cochrane Collaboration on Capsular contracture

Bandolier on Capsular contracture

TRIP on Capsular contracture

Clinical Trials

Ongoing Trials on Capsular contracture at Clinical Trials.gov

Trial results on Capsular contracture

Clinical Trials on Capsular contracture at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Capsular contracture

NICE Guidance on Capsular contracture

NHS PRODIGY Guidance

FDA on Capsular contracture

CDC on Capsular contracture

Books

Books on Capsular contracture

News

Capsular contracture in the news

Be alerted to news on Capsular contracture

News trends on Capsular contracture

Commentary

Blogs on Capsular contracture

Definitions

Definitions of Capsular contracture

Patient Resources / Community

Patient resources on Capsular contracture

Discussion groups on Capsular contracture

Patient Handouts on Capsular contracture

Directions to Hospitals Treating Capsular contracture

Risk calculators and risk factors for Capsular contracture

Healthcare Provider Resources

Symptoms of Capsular contracture

Causes & Risk Factors for Capsular contracture

Diagnostic studies for Capsular contracture

Treatment of Capsular contracture

Continuing Medical Education (CME)

CME Programs on Capsular contracture

International

Capsular contracture en Espanol

Capsular contracture en Francais

Business

Capsular contracture in the Marketplace

Patents on Capsular contracture

Experimental / Informatics

List of terms related to Capsular contracture

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [1]; Michel C. Samson, M.D., FRCSC, FACS [2]

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

Grade IV capsular contracture in the right breast of a 29-year-old woman seven years after subglandular placement of 560cc silicone gel-filled breast implants

Capsular contracture is an abnormal response of the immune system to foreign biomaterials and alloplastic materials. It is most discussed in the context of complications from breast implants and artificial joint prosthetics.

Capsules of tightly-woven collagen fibers normally form as an immune response around a foreign body (eg. breast implants, pacemakers, orthopedic joint prosthetics), tending to wall it off. Capsular contracture occurs when the capsule tightens and squeezes the implant. This contracture is a complication that can be very painful and distort the appearance of the implanted breast or limit the range of motion of a artificial joint. The exact cause of contracture is not known. However, some factors include bacterial contamination, silicone breast implant rupture or leakage, and hematoma. Capsular contracture may happen again after additional surgery.

Methods which have reduced capsular contracture include submuscular breast implant placement, using textured[1][2] or polyurethane-coated implants,[3] limiting handling of the implants and skin contact prior to insertion[4] and irrigation with triple-antibiotic solutions.[5]

Correction of capsular contracture may require surgical removal or release of the capsule, or removal and possible replacement of the implant itself. Closed capsulotomy (disrupting the capsule via external manipulation), a once common maneuver for treating hard capsules, has been discouraged as it can cause implant rupture. Nonsurgical methods of treating capsules include massage, external ultrasound,[6] treatment with leukotriene pathway inhibitors (Accolate, Singulair),[7] [8]and pulsed electromagnetic field therapy.[9]

There are four grades of breast capsular contracture - Baker grades I through IV. The Baker grading is as follows:

  • Grade I the breast is normally soft and looks natural
  • Grade II the breast is a little firm but looks normal
  • Grade III the breast is firm and looks abnormal
  • Grade IV the breast is hard, painful, and looks abnormal.

Sources

References

  1. Barnsley GP (2006). "Textured surface breast implants in the prevention of capsular contracture among breast augmentation patients: a meta-analysis of randomized controlled trials". Plast Reconstr Surg. 117 (7): 2182–90. PMID 16772915.
  2. Wong CH, Samuel M, Tan BK, Song C. (2006). "Capsular contracture in subglandular breast augmentation with textured versus smooth breast implants: a systematic review". Plast Reconstr Surg. 118 (5): 1224–36. PMID 17016195.
  3. Handel N; et al. (2006). "Long-term safety and efficacy of polyurethane foam-covered breast implants". Aesth. Surg Journal. 26 (3): 265–74. Unknown parameter |month= ignored (help)
  4. Mladick RA (1993). ""No-touch" submuscular saline breast augmentation technique". Aesth. Surg Journal. 17 (3): 183–92. PMID 8213311.
  5. Adams WP jr.; et al. (2006). "Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six-year prospective clinical study". Plast Reconstr Surg. 117 (1): 30–36. PMID 16404244.
  6. Planas J (2001). "Five-year experience on ultrasonic treatment of breast contractures". Aesthetic Plast Surg. 25 (2): 89–93. PMID 11349308.
  7. Schlesinger SL, wt al (2002). "Zafirlukast (Accolate): A new treatment for capsular contracture". Aesthetic Plast Surg. 22 (4): 329–336.
  8. Scuderi N; et al. (2006). "The effects of zafirlukast on capsular contracture: preliminary report". Aesthetic Plast Surg. 30 (5): 513–20. PMID 16977359.
  9. Silver H (1982). "Reduction of capsular contracture with two-stage augmentation mammaplasty and pulsed electromagnetic energy (Diapulse therapy)". Plast Reconstr Surg. 69 (5): 802–8. PMID 7071225.

External links

Cleft lip and palate Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Treatment

Surgery

Psychosocial Issues

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Capsular contracture On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Capsular contracture

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Capsular contracture

CDC on Capsular contracture

Capsular contracture in the news

Blogs on Capsular contracture

Directions to Hospitals Treating Cleft lip and palate

Risk calculators and risk factors for Capsular contracture

Template:SIB

Template:WS