Suppressive Effect of Leukotriene Antagonists on Capsular Contracture in Patients Who Underwent Breast Surgery with Prosthesis

2020 ◽  
Vol 145 (4) ◽  
pp. 901-911 ◽  
Author(s):  
Yuanliang Wang ◽  
Jing Tian ◽  
Jianshu Liu
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mathias Ørholt ◽  
Frederik L. Aaberg ◽  
Louise E. Rasmussen ◽  
Andreas Larsen ◽  
Mikkel Herly

Author(s):  
Andrei Pașca ◽  
Eduard-Alexandru Bonci ◽  
Codruța Chiuzan ◽  
Nicoleta Monica Jiboc ◽  
Vlad Alexandru Gâta ◽  
...  

Abstract Background Capsular Contracture (CC) is the most common long-term complication of breast surgery with prosthesis. Leukotriene Receptor Antagonists (LRAs) have been tested as a potential treatment; however, mixed results have been observed. Objectives This study presents a meta-analysis to clarify the treatment and prophylactic capabilities of LRAs in the management of CC. Methods A systematic literature search in the most popular English databases was performed to identify relevant primary publications. We included all studies that evaluated the treatment and preventive capabilities of LRAs using the Baker scale assessment. Results Six eligible studies were included based on predefined inclusion and exclusion criteria, totalling 2276 breasts, out of which 775 did not receive LRAs and 1501 did. Final pooled results showed that LRAs could help manage CC with a Risk Difference (RD) of -0.38 with the corresponding 95% Confidence Interval (CI) between -0.69 and -0.08, showing statistical significance at a Z value of 2.48, p=0.01. Subgroup analysis based on the type of drug used showed that only montelukast yielded statistical significance (RD=-0.27, 95% CI between -0.51 and -0.03, Z=2.20, p=0.03). Zafirlukast did not seem to influence CC. Further subgroup analysis based on treatment timing showed that prophylaxis was ineffective and only treatment for ongoing CC yielded statistical significance. Conclusions The current meta-analysis proved that LRAs could be used in the management of CC. Only treatment for the ongoing CC showed statistical significance. Montelukast seemed to be more efficient with a safer profile for adverse effects, while zafirlukast yielded no statistical significance.


2021 ◽  
pp. 1145-1150
Author(s):  
Emily G. Clark ◽  
Melissa A. Mueller ◽  
Gregory R.D. Evans

Debated topics and new and evolving techniques in breast surgery are discussed in this chapter. Antibiotics and the use of closed-suction drains vary among surgeons, but the existing evidence favours discontinuation of antibiotics within 24 hours in most cases, and the indications for drains are limited but include breast reconstruction with acellular dermal matrix (ADM). ADM is a biological tissue substitute with many applications in breast surgery. The product selected and surgical technique used are often case specific; cost and patient anatomy play major roles. Although not suitable for all patients, ADM is an asset to prosthetic breast reconstruction. In addition, ADM is useful in the correction of breast surgery complications, including malpositioning and capsular contracture. It may be combined with fat grafting to mask rippling. Fat grafting, or lipomodelling, is an evolving science with promising results. Technique is critical for good results, and is described in this chapter. Radiographic changes after fat grafting are usually discernible from suspicious lesions, and growing evidence supports the oncological safety of this procedure


2017 ◽  
Vol 139 (4) ◽  
pp. 819-826 ◽  
Author(s):  
Maurizio Bruno Nava ◽  
Nicola Rocco ◽  
Giuseppe Catanuto ◽  
Joanna Frangou ◽  
Corrado Rispoli ◽  
...  

2020 ◽  
Vol 40 (9) ◽  
pp. NP480-NP490 ◽  
Author(s):  
Jay W Calvert ◽  
Millicent O Rovelo ◽  
Marc V Orlando ◽  
Edwin Kwon

Abstract Background Autologous costal cartilage is frequently required for revision rhinoplasties and for challenging primary rhinoplasties. Patients undergoing a concomitant breast surgery can have costal cartilage harvested through their breast surgery incisions, thereby obviating an additional rib harvest scar. The safety and efficacy of this approach has yet to be described. Objectives The aim of this study was to evaluate the outcomes, safety, and results of a new technique, described here, for harvesting costal cartilage during a concomitant breast operation. Specifically, the rates of capsular contracture and rhinoplasty revisions were of great interest. Methods A retrospective review was performed evaluating the senior author’s experience with this technique. Data collected included patient demographics, operations performed, operative time, perioperative morbidity, and postoperative complications. Rates of capsular contracture and rhinoplasty revisions were compared with national averages. Results A total of 31 female patients were included. Ten (32.3%) breast complications occurred. There were 6 (19.4%) rhinoplasty complications, comprising 1 infection and 5 revisions. The capsular contracture rate was 6% and the rhinoplasty revision rate was 16%. Both of these rates are comparable to independent breast surgeries and rhinoplasties. There were no cases of perioperative mortality or major morbidity. Conclusions Combining breast surgery and rhinoplasty surgery allows for autologous rib harvest through the breast surgery incisions. This is a safe technique that results in outcomes similar to either procedure performed alone. In addition, the patient is spared an additional surgery and donor site scar. Level of Evidence: 4


2015 ◽  
Vol 136 (5) ◽  
pp. 592e-596e ◽  
Author(s):  
Ruth Graf ◽  
Adriana S. K. Ascenço ◽  
Renato da S. Freitas ◽  
Priscilla Balbinot ◽  
Carolina Peressutti ◽  
...  

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