Capsular contracture in patients with augmentation mammoplasties: Imaging evaluation, a narrative review.

Abstract

The placement of breast implants currently represents a tool for aesthetic and reconstructive purposes. Like any surgical procedure, augmentation mammoplasty can be associated with adverse effects in the short, medium and long term, Capsular Contracture (CC) being the most common complication. Its etiology has been extensively studied and it has been concluded that the pathogenesis is multifactorial. CC is produced because the body creates a capsule of fibrous tissue around the breast implant. There are patients where this fibrotic response occurs severely, causing thickening and/or calcification of the periprosthetic capsule, causing intense pain, excessive firmness, and deformity of the affected breast. Another theory proposes the role of a biofilm of gram-positive germs that together with the inflammatory process develop this entity. Currently, the diagnosis and severity of CC are clinically evaluated using the Baker scale, this system takes into account the sensitivity, texture and appearance of the breast. However, this classification is widely used worldwide, it is still quite subjective, generating the need for other more objective, reliable and reproducible evaluation tools. Given this, we find as a potential solution the clinical complement with sensitive and specific imaging methods for the evaluation of breast implants such as high-resolution ultrasound and magnetic resonance imaging. In which the findings range from thickening of the covered capsule complex, changes in the morphology of the implant, presence of folds, among others.