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Acellular dermal matrix-assisted breast reconstruction has low incidence of capsular contracture

There was a low cumulative incidence of capsular contracture in patients with acellular dermal matrix–assisted breast reconstruction, according to long-term study results.

“Clinically significant capsular contracture … is characterized by implant firmness/tightness, deformation, dislocation and pain,” the researchers wrote. “Although not a life-threatening complication, capsular contracture causes significant discomfort and psychologic distress, and adversely impacts the quality of life of afflicted individuals.”

The researchers conducted a retrospective chart review of 863 patients (mean age, 47 years) who underwent acellular dermal matrix–assisted breast reconstruction between December 2001 and May 2014 at two medical institutions.

There were 1,584 direct-to-implant reconstructions performed, with a mean follow-up of 4.7 years. Nine patients were diagnosed with clinically significant capsular contracture for a cumulative incidence rate of 0.8%. All capsular contractures occurred within the first 2 years after reconstructive surgery.

Patients had a 5.6-fold increased odds for developing contracture with smaller implant size (< 400 ml), and a 6.1-fold increased odds with postoperative radiotherapy. There was a 1.9% incidence of capsular contracture in irradiated breasts. Compared with a 0.7% incidence in nonirradiated breasts, but the difference was not significant.

 “In this study spanning 13 years, the cumulative incidence of capsular contracture with acellular dermal matrix–assisted, direct-to-implant reconstruction remains low, even in irradiated breasts,” the researchers concluded. “Capsular contracture appears to be an early event, occurring within the first 2 years after reconstruction.”  – by Bruce Thiel

Disclosure: Salzberg reports no relevant financial disclosures. Please see the full study for other researchers’ relevant financial disclosures.