Aesthetic Plastic Surgery

, Volume 32, Issue 2, pp 303–306 | Cite as

Relationship of Incision Choice to Capsular Contracture

Original Article



Capsular contracture can be an ongoing problem in breast augmentation even with good surgical technique. In the author’s practice, a higher incidence of capsular contracture was observed with the use of a periareolar incision than with an inframammary incision.


A review of breast augmentations performed from November 2004 through June 2006 was conducted. This analysis included the incision used, the procedure performed, and the development of capsular contracture.


The incidence of contracture was 0.59% in the inframammary group and 9.5% in the periareolar group. This increase in capsular contracture with a periareolar incision was statistically significant. Capsular contracture occurring with augmentation performed at the time of a periareolar mastopexy was 8%, which was statistically significant compared with the inframammary group. The difference in contracture rates between a periareolar incision alone and a periareolar mastopexy was not statistically significant.


Breast augmentation through a periareolar incision has a higher incidence of capsular contracture than observed with an inframammary incision. This most likely occurs due to an increase in contamination of the breast pocket with intraductal material colonized by bacteria. The periareolar incision is, and will remain, a standard of care. Therefore, this information can help clinicians make a more informed decision regarding incision placement for breast augmentation.


  1. 1.
    Adams WP, Rios JL, Smith SJ (2006) Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: Six-year prospective clinical study. Plast Reconstr Surg 117:30PubMedCrossRefGoogle Scholar
  2. 2.
    Editors, SA Perspectives (2007) Meet resistance head-on. Sci Am 296:8Google Scholar
  3. 3.
    Henriksen JK, Kjoller K, Hoyer AP, Olsen JH, Friis S (2005) Surgical intervention and capsular contracture after breast augmentation: A prospective study of risk factors. Ann Plast Surg 54:343PubMedCrossRefGoogle Scholar
  4. 4.
    Information for women about the safety of silicone breast implants (2000) Institute of Medicine. National Academies Press, Washington, DCGoogle Scholar
  5. 5.
    Netscher DT (2004) Letter to the editor regarding subclinical infection as a possible cause of significant breast capsules. Plast Reconstr Surg 113:2229PubMedCrossRefGoogle Scholar
  6. 6.
    Netscher DT, Weizer G, Wigoda P, Walker LE, Thornby J, Bowen D (1995) Clinical relevance of positive breast periprosthetic cultures without overt infection. Plast Reconstr Surg 96:1125PubMedCrossRefGoogle Scholar
  7. 7.
    Mladick RA (2005) Letter to the editor regarding significance of Staphylococcus epidermidis causing subclinical infection. Plast Reconstr Surg 115:1426PubMedCrossRefGoogle Scholar
  8. 8.
    Safety of silicone implants (1999) Institute of Medicine. National Academies Press, Washington, DCGoogle Scholar
  9. 9.
    Spear SL, Boehmler JH, Clemens MW (2006) Augmentation/mastopexy: A 3-year review of a single surgeon’s practice. Plast Reconstr Surg 118:136sPubMedCrossRefGoogle Scholar
  10. 10.
    Pajkos AB, Deva A, Vickery K, Cope C, Chang LR, Cossart FRC (2003) Detection of subclinical infection in significant breast implant capsules. Plast Reconstr Surg 111:1605PubMedCrossRefGoogle Scholar
  11. 11.
    Wiener TC (2007) The role of Betadine irrigation in breast augmentation. Plast Reconstr Surg 119:12PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.HoustonUSA

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