Reducing Capsular Contracture Rate during Surgery for Breast Augmentation

Plastic surgeons have tried reducing capsular contracture rate through different means during surgery.  Routinely, antibacterial lavage with topical antibiotics is performed during surgery prior to placement of the breast implants to possibly reduce the infection rate and possibly the occurrence of capsular contracture (CC) in breast augmentation.

In the study conducted by Giordano, patients in his retrospective study underwent breast augmentation with the same surgeon via the inframammary approach and dual-plane pocket. In group A, patients received a single perioperative dose of 1.5 g of intravenous cephalothin and 750 mg of oral cephalexin twice a day for 7 days after discharge. In group B, patients perioperatively received 750 mg of intravenous cefuroxime, and each implant and pocket were irrigated with 25 mL of a 10% povidone-iodine solution mixed with 750 mg of cefuroxime and 80 mg of gentamicin diluted in 15 mL of 0.9% sodium chloride solution. After discharge, patients received 500 mg of oral levofloxacin once a day for 5 days.

• The postoperative superficial wound infection rate in their study was 1.8% and 1.2%; the seroma rate was 1.8% and 1.2%; and the hematoma rate was 0.6% and 1.2% in groups A and B, respectively. Ten Capsular contracture cases (Baker grade 3 or 4) in group A and 1 in group B were reported (6% vs 0.6%; P = .006).
• Povidone-iodine and antibiotic irrigation in cosmetic breast augmentation yielded a lower capsular contracture rate than standard perioperative antibiotics.

Reference:

Giordano, et al. Povidone-iodine combined with antibiotic topical irrigation to reduce capsular contracture in cosmetic breast augmentation: a comparative study. AestheticSurgery J. 2013 Jul;33(5):675-80. doi: 10.1177/1090820X13491490. Epub 2013 Jun 11.