Pharmacological approaches for the prevention of breast implant capsular contracture

Eugénie Guimier, Louise Carson, Benny David, James Lambert, Enda Heery, Karl Malcolm

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Capsular contracture is a common complication associated with breast implants following reconstructive or aesthetic surgery in which a tight or constricting scar tissue capsule forms around the implant, often distorting the breast shape and resulting in chronic pain. Capsulectomy (involving full removal of the capsule surrounding the implant) and cap- sulotomy (where the capsule is released and/or partly removed to create more space for the implant) are the most common surgical procedures used to treat capsular contracture. Various structural modifications of the implant device (including use of textured implants, submuscular placement of the implant, and the use of polyurethane-coated implants) and surgical strategies (including pre-operative skin washing and irrigation of the implant pocket with antibiotics) have been and/or are currently used to help reduce the incidence of capsular contracture. In this article, we review the pharmacological approachesdboth commonly practiced in the clinic and experimentaldreported in the scientific and clinical literature aimed at either preventing or treating capsular contracture, including (i) pre- and post-operative intravenous administration of drug substances, (ii) systemic (usually oral) administration of drugs before and after surgery, (iii) modification of the implant surface with grafted drug substances, (iv) irrigation of the implant or peri-implant tissue with drugs prior to implantation, and (v) incorporation of drugs into the implant shell or filler prior to surgery followed by drug release in situ after implantation.
Original languageEnglish
Pages (from-to)129–150
Number of pages22
JournalJournal of Surgical Research
Early online date12 Aug 2022
Publication statusPublished - Dec 2022


  • breast implants
  • capsular contracture
  • breast augmentation and reconstruction
  • silicone elastomer


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