Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;16(4):350-357.
doi: 10.1159/000509598. Epub 2020 Oct 16.

Implant Replacement or Removal: What Happens after Capsular Contracture? A German Study Examining Breast Implant Revision Surgery and Patient Choices in 946 Cases

Shafreena Kühn  1 , Mara Anna Georgijewitsch  2 , Andrej Wehle  1 , Moritz Billner  3 , Lara Küenzlen  1 , Jens Rothenberger  1 , Ulrich Michael Rieger  1
Affiliations

Implant Replacement or Removal: What Happens after Capsular Contracture? A German Study Examining Breast Implant Revision Surgery and Patient Choices in 946 Cases

Shafreena Kühn et al. Breast Care (Basel). 2021 Aug.

Abstract

Introduction: Capsular contracture most often leads to implant revision surgery for aesthetic or reconstructive purposes. However, little is known about which operation is chosen when revision surgery has to be performed. We performed analysis of revision indications and performed revision surgery considering implant removal or replacement and additional surgical procedures. To our knowledge, this study presents the largest German single-center analysis regarding implant revision surgery after the onset of complications.

Methods: Retrospective 10-year data analysis of a single-center population undergoing breast implant revision surgery.

Results: Capsular contracture was the most frequent finding before reoperation, both removal and replacement (p < 0.05). It was linked to longer duration of in situ implant placement (p < 0.05) and more frequently in reconstructive patients (p < 0.05). Implant replacement was performed more often before definite implant removal for reconstructive patients (p < 0.05). Mean duration of in situ implant placement before definite removal was lower for reconstructive patients (p = 0.005). Overall reconstructive patients were older than aesthetic patients (p < 0.05). After implant removal, 61.7% of aesthetic patients chose to undergo mastopexy, 54.7% of reconstructive patients opted for autologous breast reconstruction, and 25.4% did not choose an additional surgical procedure after implant removal.

Conclusion: Significant differences are observed for reconstructive and aesthetic patients regarding indication leading to revision surgery, time of revision surgery, and the type of performed revision surgery itself. After implant removal, more than 60% of aesthetic patients undergo mastopexy, more than half of reconstructive patients choose autologous breast reconstruction, and over a quarter of patients choose no additional surgical procedures.

Keywords: Breast augmentation; Breast surgery; Capsular contracture; Implants; Mastopexy.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Overview of all patients and breast implants placed according to initial purpose of implant placement and revision surgery. Numbers and figures refer to number of breasts.
Fig. 2
Fig. 2
a 35-year-old patient with bilateral capsular contracture 12 years after aesthetic breast augmentation. b Six months after capsular excision and implant replacement.
Fig. 3
Fig. 3
a 60-year-old patient with bilateral waterfall deformity 14 years after aesthetic breast augmentation. b Six months after implant removal and mastopexy.
Fig. 4
Fig. 4
a 40-year-old patient with capsular contracture after implant placement following incomplete mastectomy for breast cancer (left side). b Six months after implant removal and autologous tissue transfer (DIEP-Flap).
Fig. 5
Fig. 5
Overview of revision surgery performed for all patients (n = 591). * Includes implant removal and lipofilling or ablation of the breast.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kühn S, Rieger UM. Ästhetische Operationen - nimmt der Trend zu? gynäkologische praxis. 2018;((44/2)):309–316.
    1. International Society of Aesthetic Plastic Surgery [Internet] ISAPS INTERNATIONAL SURVEY ON AESTHETIC/COSMETIC PROCEDURES performed in. 2018 Available from https://www.isaps.org/wp-content/uploads/2019/12/ISAPS-Global-Survey-Res....
    1. Champaneria MC, Wong WW, Hill ME, Gupta SC. The evolution of breast reconstruction: a historical perspective. World J Surg. 2012 Apr;36((4)):730–42. - PubMed
    1. Billner M, Wirthmann A, Reif S, Rieger UM. Poly Implant Prothèse and Rofil Substandard Breast Implant Explantations from a Large German Single Centre from 2011 to 2014: A Comparative Study. Aesthetic Plast Surg. 2016 Aug;40((4)):507–13. - PubMed
    1. Gabriel SE, Woods JE, O'Fallon WM, Beard CM, Kurland LT, Melton LJ., 3rd Complications leading to surgery after breast implantation. N Engl J Med. 1997 Mar;336((10)):677–82. - PubMed