TEXTURED OR SMOOTH IMPLANTS FOR SUBMUSCULAR BREAST AUGMENTATION - A CONTROLLED-STUDY

Capsular contracture consistently has been the most frequently noted c omplication of submuscular and subglandular breast augmentation. The e tiology of this complication is still unknown, although silicone bleed , hematoma, infection, foreign bodies, and surgical trauma have been i mplicated. In this prospective, double-blind study, 61 women undergoin g submuscular breast augmentation were randomized between Dow Coming t extured and smooth-walled silicone gel implants. Any consequent capsul ar contracture was assessed by an independent plastic surgeon and also by the patients themselves. Objective evaluation was made by applanat ion tonometry. It was found that depending on doctors, patients, and o bjective method used, 3 to 9 percent grade III and IV encapsulation fo llowed submuscular augmentation with textured implants and 10 to 20 pe rcent with smooth-walled implants after 1 year. The differences were s ignificant according to both patient assessment and applanation tonome try but not according to the physicians' evaluations. There was no cor relation of capsular contracture with the age of the patient, duration of the operation, or degree of blood loss. There was a small but inco nclusive difference in capsular contracture rate that favored the plac ement of textured rather than smooth implants in the submuscular pocke t.