Aesthetic Plastic Surgery

, 35:828

Maximizing the Use of Precapsular Space and the Choice of Implant Type in Breast Augmentation Mammaplasty Revisions: Review of 49 Consecutive Procedures and Patient Satisfaction Assessment

  • Manuel Francisco Castello
  • Davide Lazzeri
  • Alessandro Silvestri
  • Tommaso Agostini
  • Christian Pascone
  • Claudio Marcelli
  • Diego Gigliotti
  • Carlo D’Aniello
  • Marco Gasparotti
Original Article

DOI: 10.1007/s00266-011-9704-1

Cite this article as:
Castello, M.F., Lazzeri, D., Silvestri, A. et al. Aesth Plast Surg (2011) 35: 828. doi:10.1007/s00266-011-9704-1

Abstract

Background

Capsular contracture, implant malposition and displacement, breast asymmetry, improper contour, and symmastia may compromise the aesthetic outcome of breast augmentation and usually require surgical correction. Correction of these deformities may be achieved by accommodating a new implant in a novel pocket created in the precapsular space in either the subpectoral or subglandular plane. This article describes a modality to correct adverse results of augmentation mammaplasty and evaluates patient satisfaction.

Methods

Precapsular reaugmentation was performed in 49 patients who underwent cosmetic breast surgery revisions from 2004 to 2009. All patients had previously received breast implants but complained of implant malposition and dislocation, implant size change, capsular contracture, and symmastia. A precise neoprecapsular pocket was developed above the old anterior implant capsule wall, with dissection limited to create only the space necessary for proper placement of the implant. Patients were evaluated for resolution of symptoms, satisfaction, and complications.

Results

Implant malposition and rippling, capsular contracture, breast asymmetry, and symmastia were the most common complaints from the first augmentation. Nineteen women had subpectoral implant placement, 12 had subglandular, and the rest (n = 18) had “dual-plane” location of their implants. We used textured silicone implants in 17 cases and polyurethane-coated prostheses in the remaining 32 cases. The average follow-up time was 24.1 months. Breast augmentation-related complications had resolved in all patients without any recurrence to date. The overall complication rate was very low and patient satisfaction with this procedure was extremely high.

Conclusion

The creation of a neoprecapsular pocket combined in peculiar cases with the placement of polyurethane-coated implants is a versatile option that offers an effective one-stage solution for the correction of cosmetic mammaplasty-induced deformities.

Keywords

Secondary mammaplasty Breast augmentation revision Capsular contracture Symmastia Precapsular space Patient satisfaction 

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  • Manuel Francisco Castello
    • 1
  • Davide Lazzeri
    • 2
  • Alessandro Silvestri
    • 1
  • Tommaso Agostini
    • 3
  • Christian Pascone
    • 3
  • Claudio Marcelli
    • 1
  • Diego Gigliotti
    • 1
  • Carlo D’Aniello
    • 2
  • Marco Gasparotti
    • 1
  1. 1.Divisione di Chirurgia Plastica e RicostruttivaClinica Ars MedicaRomaItaly
  2. 2.Plastic and Reconstructive Surgery UnitUniversity Hospital of SienaSienaItaly
  3. 3.Burn Center UnitHospital of PisaPisaItaly

Personalised recommendations