Capsular
contracture remains a challenging complication of implant-based aesthetic breast surgery despite improvements in implant design. The lowering of capsular
contracture rates noted with the past use of
polyurethane foam-covered implants has increased awareness of the importance of the
biologic response at the interface between the implant surface and breast tissue. Emerging evidence indicates that much like the
polyurethane foam, acellular dermal matrices alter the
biologic response at the surface interface, resulting in a more vascular and less constrictive pattern of
collagen deposition. This study reports on the authors' clinical experience using
Strattice Reconstructive Tissue Matrix (LifeCell Corporation, Branchburg, N.J.) for the treatment of capsular
contracture in patients with established capsules and for prevention in patients undergoing primary augmentation or augmentation/mastopexy. Of 80 patients (154 breasts) in whom
Strattice was used, clinically significant
contracture (Baker grade III/IV) occurred in three breasts (3.75 percent), all of which were in the treatment of previous
contracture group. In addition, the authors noted two
seromas requiring implant removal (both patients developed capsules, as mentioned above) and two
hematomas requiring revision, for an overall failure rate of 6.25 percent for
Strattice-assisted surgery. The data confirm that the use of
Strattice significantly lowers the incidence of capsular
contracture in the first 3.5 years after implant placement.