Risk factors for capsular contracture: a study of 91 537 breast implants over 6 years from the Australian Breast Device Registry

BACKGROUND: Capsular Contracture (CC) is a key downstream complication of breast implant surgery captured by breast implant registries worldwide. A number of factors have a been linked to CC development including smooth implants and bacterial contamination. The purpose of this study was to analyze prospectively captured data from the Australian Breast Device Registry to investigate the risk of capsular contracture with respect to patient demographics, the use of contamination minimization measures (CMM), implant characteristics and variations in surgical technique. METHODS: These data were extracted from the Australian Breast Device Registry including 91 537 implants and analyzed against patient demographics, CMMs, implant characteristics and variations in surgical technique to determine which factors were associated with reducing capsular contracture risk. RESULTS: A variety of factors including use of nipple shields, antiseptic rinse, changing gloves for insertion and anatomic implant shape were associated with significantly reduced rates of capsular contracture. CONCLUSIONS: Our findings show that the change of gloves, the use of antiseptic rinse and the use of nipple shields significantly reduce the risk of CC following cosmetic breast augmentation. These findings further support the importance of minimizing bacterial contamination at the time of implant placement and the need for clinicians to be appropriately trained, vigilant and aim for the highest standards of infection control and sterile technique when using breast implants for any indication.