Abstract
Capsular contracture is the one the most common complications following implant based breast augmentation and remains a common reason for reoperation. Despite this, there is still uncertainty regarding the pathogenesis and the best way to treat capsular contracture, as well as what can be done to reduce its incidence. There is a consensus that contracture occurs due to an excessive fibrotic reaction to a foreign body (the implant) and risk factors include the use of a smooth (vs. textured) implant, a silicone (vs. saline filled) implant, a subglandular (vs. submuscular) placement and previous radiotherapy. Current management involves a capsulectomy or capsulotomy usually, and medical management using the off-label leukotriene antagonist Zafirlukast has been reported to reduce severity and help prevent contracture. However, both approaches are associated with a significant recurrence rate. Recent research has focussed on ways to prevent capsular contracture from developing in the first instance, or novel treatment strategies such as autologous fat transfer.
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