Shauly O, Gould DJ, Patel KM. Microtexture and the Cell/Biomaterial Interface: A Systematic Review and Meta-Analysis of Capsular Contracture and Prosthetic Breast Implants.
Aesthet Surg J 2019;
39:603-614. [PMID:
30124780 DOI:
10.1093/asj/sjy178]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND
The use of textured breast implants over smooth implants has been widely shown to have a lower incidence of capsular contracture. However, the impact of micropatterning techniques on the incidence of postoperative patient morbidity has not been comprehensively investigated.
OBJECTIVES
The authors sought to examine the incidence of capsular contracture, seroma, and implant rippling among the 3 major micropatterning techniques applied in the manufacturing of textured breast implants.
METHODS
Literature searches of PubMed/Medline and Embase between 1995 and 2017 were performed, and 19 studies were selected for analysis. Data from each study were extracted into a form including mean age, study design, population size, mean follow-up, number of capsular contracture cases, number of seroma cases, and number of rippling cases. Meta-analysis was performed separately for studies that included capsular contracture rates for foam textured implants, imprinted textured implants, and salt-loss textured implants.
RESULTS
The pooled rate of capsular contracture rates in primary augmentation patients was 3.80% (95% CI, 2.19-5.40) for imprinted textured implants, 4.90% (95% CI, 3.16-6.64) for foam textured implants, 5.27% (95% CI, 3.22-7.31) for salt-loss textured implants, and 15.56% (95% CI, 13.31-18.16) for smooth implants. The results of each meta-analysis were summarized on a forest plot depicting the distribution of capsular contracture rates from each study.
CONCLUSIONS
Micropatterning of prosthetic implants could drastically reduce postoperative patient morbidity given the advent of recent technologies that allow for more detailed texturing of implant surfaces.
LEVEL OF EVIDENCE: 4
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