Risk Factors for Capsular Contracture: A Retrospective Study in Immediate Reconstruction versus Delayed Reconstruction

BACKGROUND:Capsular contracture is a common complication among breast implant reconstruction patients. The aim of this study was to assess the duration of and risk factors associated with capsular contracture by comparing 2 reconstruction methods. METHODS:The medical charts of patients who received a reconstructed breast implant and underwent a capsule revision surgery were retrospectively reviewed. We examined patients’ background, skin expansion duration, time taken until capsule revision surgery, tissue expander/implant size, and postoperative complications. RESULTS:Of the total 74 breasts [42 immediate reconstruction (Immediate) and 32 delayed reconstruction (Delayed) breasts], the age at the revision surgery was significantly older in the Delayed (59 years) than in the Immediate category (50 years; P = 0.002). The time taken until the capsule revision surgery was significantly shorter for the Immediate (63.5 months) than for the Delayed (121 months; P < 0.0001). The postoperative complication rate after expander insertion was significantly higher in the Immediate (62.5%) than in the Delayed (21.1%; P < 0.0001). The size of the expander and implant was significantly smaller in the Immediate (expander, 300 mL; implant, 240 mL) than in the Delayed (expander, 400 mL; implant, 300 mL) (expander, P = 0.008; implant, P = 0.004). CONCLUSIONS:The immediate reconstruction breasts had a shorter time to capsule revision surgery than the delayed reconstruction breasts. Our study suggested that the shorter time in immediate reconstruction was affected by postoperative complications after mastectomy with expander insertion and by selection of a smaller sized expander and implant.