Abstract
Capsular contracture is the formation of a fibrous periprosthetic shell as a foreign body response. The capsule has a trilaminar structure. The inner layer consists of a synovial-type metaplasia from fibrocytes and histiocytes, the intermediate layer of smaller fibrils in a vessel-rich network, and the outer layer of densely packed collagen fibers. Myofibroblasts sit in the outer layer, and the capsule may constrict and cause pain and deformation of the implant. Capsular contracture despite advances in surgical technique and implant devices remains a frequent complication after breast reconstruction (2.8–15.9%) [1, 2]. With the adjunct of radiotherapy, a recognized risk factor, capsular contracture rates of 15–50% have been reported [3–8]. In 20–30%, revision surgery has to be performed because of capsular contracture [9–12]. Capsular contracture, because of the multifactorial and in part still unclear etiology, the impairment of quality of life, and the significant economic impact, is subject of greatest interest in plastic and reconstructive surgery.
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