Capsular
contracture is a highly distressing, difficult complication after breast augmentation for both the patient and the surgeon. Although capsular
contracture is a multifactorial process, one common denominator in the successful treatment of this complication is believed to be the abatement of
inflammation.
Leukotriene antagonists have recently emerged as effective prophylactic agents in reactive airway diseases. Anecdotal reports have indicated that
zafirlukast (
Accolate, AstraZeneca) effectively reverses capsular
contracture. A prospective study of capsular
contracture in 120 female patients in whom a total of 216
prostheses were implanted was performed. The hardness of capsular
contracture was assessed by means of the mammary compliance method (Anton Paar Mammacompliance system). The patients were divided into two groups: patients in group A received
zafirlukast for a 6-month period, while those in group B received
vitamin E. The results show a significant decrease of the values of breast compliance after 6 months in group A but not in group B and that the variation in compliance after 6 months in group A compared to group B is statistically significant. In
zafirlukast-treated patients, we observed a reduction in mammary compliance of 7.69 percent after 1 month, 16.78 percent after 3 months and 24.01 percent after 6 months. The present study suggests that
zafirlukast may be effective in reducing
pain and breast
capsule distortion in patients with longstanding
contracture who are either not surgical candidates or who do not wish to undergo surgery.