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Is Ultracision Knife Safe and Efficient for Breast Capsulectomy? A Preliminary Study

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Abstract

Background

Silicone breast implants are used to a wide extent in the field of plastic surgery. However, capsular contracture remains a considerable concern. This study aimed to analyze the effectiveness and applicability of an ultracision knife for capsulectomy breast surgery.

Methods

A prospective, single-center, randomized study was performed in 2009. The inclusion criteria specified female patients 20–80 years of age with capsular contracture (Baker 3–4). Ventral capsulectomy was performed using an ultracision knife on one side and the conventional Metzenbaum-type scissors and surgical knife on the collateral side of the breast. Measurements of the resected capsular ventral fragment, operative time, remaining breast tissue, drainage time, seroma and hematoma formation, visual analog scale pain score, and sensory function of the nipple–areola complex were assessed. In addition, histologic analysis of the resected capsule was performed.

Results

Five patients (median age, 59.2 years) were included in this study with a mean follow-up period of 6 months. Three patients had Baker grade 3 capsular contracture, and two patients had Baker grade 4 capsular contracture. The ultracision knife was associated with a significantly lower pain score, shorter operative time, smaller drainage volume, and shorter drainage time and resulted in a larger amount of remaining breast tissue. Histologic analysis of the resected capsule showed no apoptotic cells in the study group or control group.

Conclusions

The results suggest that ventral capsulectomy with Baker grade 3 or 4 contracture using the ultracision knife is feasible, safe, and more efficient than blunt dissection and monopolar cutting diathermy and has a short learning curve.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.

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Acknowledgments

We thank Dr. Daniel Haselbach for preparation of the ethical commission submission. We thank Prof. Gerhard Pierer, MD, and Martin Haug, MD, University of Basel, for administrative support. Material for this study was kindly provided by Ethicon Endo-Surgery GmbH, Norderstedt, Germany. The Harmonic Synergy Curved Blade (SNGCB; Ethicon Endo-Surgery LLC, USA) was used in this study.

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Authors and Affiliations

  1. Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland

    Mathias Tremp, Dirk J. Schaefer & Daniel F. Kalbermatten

  2. Division of Plastic, Reconstructive, and Aesthetic Surgery CHUV, University Hospital of Lausanne, Lausanne, Switzerland

    Pietro G. di Summa, Dominique Schaakxs, Wassim Raffoul & Daniel F. Kalbermatten

  3. Department of Plastic, Reconstructive, and Aesthetic Surgery, University Innsbruck, Innsbruck, Austria

    Ulrich Rieger

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  1. Mathias Tremp
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  2. Pietro G. di Summa
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  3. Dominique Schaakxs
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  4. Ulrich Rieger
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Correspondence to Daniel F. Kalbermatten.

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Tremp, M., di Summa, P.G., Schaakxs, D. et al. Is Ultracision Knife Safe and Efficient for Breast Capsulectomy? A Preliminary Study. Aesth Plast Surg 36, 888–893 (2012). https://doi.org/10.1007/s00266-012-9896-z

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  • DOI: https://doi.org/10.1007/s00266-012-9896-z

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