Does the Use of Intraoperative Breast Sizers Increase Complication Rates in Primary Breast Augmentation? A Retrospective Analysis of 416 Consecutive Cases in a Single Institution

Background. Is the use of intraoperative breast sizers beneficial for plastic surgeons or do they result in higher complication rates? Methods. This is a retrospective study of 416 consecutive cases of primary breast augmentation with silicone implants at the Plastic Surgery Service of Professor Ivo Pitanguy at the 38th Infirmary Santa Casa Misericórdia Hospital, Rio De Janeiro, from January 2011 to March 2014. 212 cases (51%) were carried out with use of intraoperative breast sizers with 204 cases (49%) without the use of implant sizers. This study compares the outcome of cases that employed the use of intraoperative implant sizers versus those that did not in terms of infection, hematoma/seroma formation, and capsular contracture. Results. Of 416 primary breast augmentation cases, there were 5 cases of infection (1.2%), 4 cases of seroma (1%), 3 cases of hematoma (0.7%), and 7 cases of capsular contracture (Baker’s Grade III/IV)(1.7%). Total complication rate limited to infection, seroma, hematoma, and capsular contracture was 1.15% (95% CI 0.96–1.93%). There was a significant difference in the scores for breast sizers (M = 4.3, SD = 1.4) and no breast sizers (M = 2.3, SD = 0.87) conditions, t(8) = 2.79, p=0.018. The use of implant sizers was correlated with a higher complication rate. Conclusion. Good results could be obtained without the use of breast sizers in primary breast augmentation with use of a biodimensional tissue based planning system while eliminating risks of infection and reducing intraoperative time. Notwithstanding, in a residency program breast sizers can be an excellent training tool to shorten the learning curve in the novice surgeon.

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Breast implant rupture 37 years after breast augmentation

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh210401069j ◽

2021 ◽

pp. 69-69

Author(s):

Marko Jovic ◽

Ivan Radosavljevic ◽

Jovan Mihaljevic ◽

Jelena Jeremic ◽

Milan Jovanovic

Keyword(s):

Breast Augmentation ◽

First Generation ◽

Histopathological Examination ◽

Breast Implant ◽

Capsular Contracture ◽

Surrounding Tissue ◽

Silicone Implants ◽

Complication Rates ◽

Macroscopic Appearance ◽

Implant Rupture

Introduction Silicone implants have been used ever since the second half of the 20th century. Over that period several generations of implants have been developed that differed in thickness of the shell and viscosity of the silicone gel. Development of these generations of implants was accompanied with different complication rates. The first-generation implants had the lowest tendency to rupture, but were more prone to capsular contracture and calcification formation. Case outline An 81-year-old female patient had her silicone implants placed in 1983. After a chest injury in 2015. on the lateral aspect of the left breast a tumefaction becomes palpable and she complains of pain. She denies any subjective problems before the injury. After pertinent diagnostic procedures and clinical examination, silicone implant rupture was suspected. Surgical findings confirmed ruptures of both implants so that they were extracted, capsulectomy was performed and the surrounding tissue imbibed with silicone removed. Samples were sent for histopathological examination. Conclusion Implant rupture is one of late complications of breast augmentation. The incidence of ruptures has changed with development of newer generations of silicone implants. We believe that our patient had the first-generation silicone implants, knowing the time from their placement to the occurrence of symptoms and macroscopic appearance of the shell after extraction. The fact is that these implants have proved to be very durable, but regardless of the lack of symptoms, current guidelines recommend regular screening for rupture, while possible preventive extraction, particularly in case of so old implants should be considered.

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Breast augmentation with silicone implants performed without drainage - retrospective analysis of 726 cases

Vojnosanitetski pregled ◽

10.2298/vsp151115171s ◽

2017 ◽

Vol 74 (2) ◽

pp. 152-155

Author(s):

Nenad Stepic ◽

Jovana Koncar ◽

Milica Rajovic ◽

Sanja Novakovic ◽

Marijan Novakovic

Keyword(s):

Retrospective Analysis ◽

Breast Augmentation ◽

Capsular Contracture ◽

Surgical Techniques ◽

Early Postoperative Period ◽

Silicone Implants ◽

Wound Drainage ◽

Dual Plane ◽

Significant Difference ◽

Plane Technique

Introduction: Breast augmentation has been one of the most popular aesthetic procedures. Early complications, like infection, seroma, hematoma and capsular contracture like one of the most frequent long term complication, might be related to wound drainage. Aim of the study was to investigate the rate of the complications of breast augmentation procedure performed without drainage. Material and Methods. Retrospective analysis of all patients underwent breast augmentation in the period of 2003-2013 was performed. From the medical history of the patients, data related to demographic characteristics of the patients, surgical technique and rate of complications were collected. Wound drainage has not been used in any of the patients. Patients were followed at the discharge, after 7 days, three months and yearly thereafter. Wound seroma, wound hemathoma, wound infection and capsular contracture were followed. Results. There were 726 patients with average age of 28,5 year (22-48). Breast augmentation using silicone implants was performed with inframammary approach using subglandular, submuscular and dual plane technique. Average implant size was 339cc (200-520). Subglandular augmentation had 545 (75%), while, 181 (25%) received an implant in submuscular plane. Those, who were operated with dual plane technique were 86 (47,5%).In early postoperative period, there was no infection, five seromas (0,7 %) and eight hematoma (1,1%), while five of them required surgical evacuation. There was no statistical significant difference between the two surgical techniques in terms of complication rate. During follow up, there were three capsular contractures (0,4%). Conclusions. The incidence of complications in our group of patients after breast augmentation is low even though no drainage was used. Still, further randomized trials are needed to prove role of drainage in prevention of complications after breast augmentation.

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Our Experience With Transumbilical Breast Augmentation: Largest Published Series to Date With 2263 Patients

The American Journal of Cosmetic Surgery ◽

10.1177/0748806819879781 ◽

2019 ◽

Vol 37 (2) ◽

pp. 81-90

Author(s):

Ehab Akkary ◽

Shaina Contic ◽

Ethan Benning ◽

Robert Shumway

Keyword(s):

Patient Satisfaction ◽

Breast Augmentation ◽

Cosmetic Surgery ◽

Capsular Contracture ◽

Pectoralis Major Muscle ◽

Operating Time ◽

Silicone Implants ◽

Intravenous Sedation ◽

Extensive Literature ◽

Single Institution

Transumbilical Breast Augmentation (TUBA) represents a unique approach for breast augmentation (BA). The endoscopic-guided procedure allows for placement of saline breast implants above or below the pectoralis major muscle without placing any incisions on or near the breast. The procedure has not been widely adopted likely due to the high learning curve and the need for advanced endoscopic skills. In addition, silicone implants have increasingly become more popular than saline implants for multiple reasons over the years, which has naturally decreased the number of TUBA cases. Here, we present the largest series of TUBA cases performed at a single institution and present our standardized reproducible technique to promote wider application of TUBA in Cosmetic Surgery. This is a single-institution retrospective study that included 2263 patients (4526 implants) between 1994 and 2017. All cases were performed under tumescence anesthesia with monitored intravenous sedation. Operating time, conversion to another approach, early and late complications, and patient satisfaction were studied. Our data were compared with the available studies via an extensive literature review. In total, 2263 patients (4526 implants) were included in the study. There was 1 case that required unilateral intraoperative conversion to periareolar approach in the initial experience for technical difficulty. Five small postoperative hematomas occurred that were successfully treated with conservative management and did not require evacuation, and 4 out of 5 postoperative hematomas occurred in subpectoral BA and 1 occurred in subglandular BA. Average operating time was 45 minutes. Remote Grade III and IV capsular contracture occurred in 113 patients requiring capsulectomy through periareolar approach. There were 3 cases of superficial umbilical wound infection that occurred, 1 in subglandular BA and 2 in subpectoral BA. These cases were treated with oral antibiotics and local wound care. No implant infection occurred. There were 32 cases of mild asymmetry that were acceptable by patients and did not require a revision, 19 cases occurred in the subpectoral BA group, and 13 cases occurred in the subglandular BA group. The procedure yielded a very high satisfaction rate. TUBA is a safe and reproducible procedure for BA with short operative time, high patient satisfaction, and comparable outcomes with other approaches.

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Admission and Acute Complication Rate for Outpatient Lumbar Microdiscectomy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100009641 ◽

2010 ◽

Vol 37 (1) ◽

pp. 49-53 ◽

Cited By ~ 19

Author(s):

Aria Fallah ◽

Eric M. Massicotte ◽

Michael G. Fehlings ◽

Stephen J. Lewis ◽

Yoga Raja Rampersaud ◽

...

Keyword(s):

Complication Rate ◽

Admission Rate ◽

Complication Rates ◽

Chi Square ◽

Lumbar Microdiscectomy ◽

Acute Complication ◽

Admission Data ◽

Improved Outcomes ◽

Significant Difference ◽

Revision Operations

Objective:Specialization is generally independently associated with improved outcomes for most types of surgery. This is the first study comparing the immediate success of outpatient lumbar microdiscectomy with respect to acute complication and conversion to inpatient rate. Long term pain relief is not examined in this study.Methods:Two separate prospective databases (one belonging to a neurosurgeon and brain tumor specialist, not specializing in spine (NS) and one belonging to four spine surgeons (SS)) were retrospectively reviewed. All acute complications as well as admission data of patients scheduled for outpatient lumbar microdiscectomy were extracted.Results:In total, 269 patients were in the NS group and 137 patients were in the SS group. The NS group averaged 24 cases per year while the SS group averaged 50 cases per year. Chi-square tests revealed no difference in acute complication rate [NS(6.7%), SS(7.3%)] (p>0.5) and admission rate [NS(4.1%), SS(5.8%)] (p=0.4) while the SS group had a significantly higher proportion of patients undergoing repeat microdiscectomy [NS(4.1%), SS(37.2%)] (p<0.0001). Excluding revision operations, there was no statistically significant difference in acute complication [NS(5.4%), SS(1.2%)] (p=0.09) and conversion to inpatient [NS(4.3%), SS(4.6%)] (p>0.5) rate. The combined acute complication and conversion to inpatient rate was 6.9% and 4.7% respectively.Conclusion:Based on this limited study, outpatient lumbar microdiscectomy can be apparently performed safely with similar immediate complication rates by both non-spine specialized neurosurgeons and spine surgeons, even though the trend favored the latter group for both outcome measures.

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Endonasal endoscopic pituitary surgery in the elderly

Journal of Neurosurgery ◽

10.3171/2016.11.jns162286 ◽

2018 ◽

Vol 128 (2) ◽

pp. 429-436 ◽

Cited By ~ 11

Author(s):

Peter J. Wilson ◽

Sacit B. Omay ◽

Ashutosh Kacker ◽

Vijay K. Anand ◽

Theodore H. Schwartz

Keyword(s):

Elderly Patients ◽

Complication Rate ◽

Pituitary Adenomas ◽

Statistical Tests ◽

The Elderly ◽

Medical Complications ◽

Tumor Diameter ◽

Complication Rates ◽

Pseudoaneurysm Formation ◽

Significant Difference

OBJECTIVEPituitary adenomas are benign, slow-growing tumors that cause symptoms either through mass effect or hormone overproduction. The decision to operate on a healthy young person is relatively straightforward. In the elderly population, however, the risks of complications may increase, rendering the decision more complex. Few studies have documented the risks of surgery using the endonasal endoscopic approach in a large number of elderly patients. The purpose of this study was to audit a single center's data regarding outcomes of purely endoscopic endonasal transsphenoidal resection of pituitary adenomas in elderly patients and to compare them to the current literature.METHODSA retrospective review of a prospectively acquired database of all endonasal endoscopic surgeries done by the senior authors was queried for patients aged 60–69 years and for those aged 70 years or older. Demographic and radiographic preoperative data were reviewed. Outcomes with respect to extent of resection and complications were examined and compared with appropriate statistical tests.RESULTSA total of 135 patents were identified (81 aged 60–69 years and 54 aged 70 years or older [70+]). The average tumor diameter was slightly larger for the patients in the 70+ age group (mean [SD] 25.7 ± 9.2 mm) than for patients aged 60–69 years (23.1 ± 9.8 mm, p = 0.056). There was no significant difference in intraoperative blood loss (p > 0.99), length of stay (p = 0.22), or duration of follow-up (p = 0.21) between the 2 groups. There was a 7.4% complication rate in patients aged 60–69 years (3 nasal and 3 medical complications) and an 18.5% complication rate in patients older than 70 years (4 cranial, 3 nasal, 1 visual, and 2 medical complications; p = 0.05 overall and 0.013 for cranial complications). Cranial complications in the 70+ age category included 2 postoperative hematomas, 1 pseudoaneurysm formation, and 1 case of symptomatic subdural hygromas.CONCLUSIONSEndonasal endoscopic surgery in elderly patients is safe, but there is a graded increase in complication rates with increasing age. The decision to operate on an asymptomatic or mildly symptomatic patient in these age groups should take this increasing complication rate into account. The use of a lumbar drain or lumbar punctures should be weighed against the risk of subdural hematoma in patients with preexisting atrophy.

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Comparison of perioperative complications following posterior column osteotomy versus posterior-based 3-column osteotomy for correction of rigid cervicothoracic deformity: a single-surgeon series of 95 consecutive cases

Journal of Neurosurgery Spine ◽

10.3171/2020.3.spine191330 ◽

2020 ◽

Vol 33 (3) ◽

pp. 297-306

Author(s):

Darryl Lau ◽

Vedat Deviren ◽

Rushikesh S. Joshi ◽

Christopher P. Ames

Keyword(s):

Risk Factor ◽

Complication Rate ◽

Surgical Complications ◽

Deformity Correction ◽

Neurological Deficits ◽

Wedge Osteotomy ◽

Medical Complication ◽

Complication Rates ◽

Cervical Deformity ◽

Significant Difference

OBJECTIVEThe correction of severe cervicothoracic sagittal deformities can be very challenging and can be associated with significant morbidity. Often, soft-tissue releases and osteotomies are warranted to achieve the desired correction. There is a paucity of studies that examine the difference in morbidity and complication profiles for Smith-Petersen osteotomy (SPO) versus 3-column osteotomy (3CO) for cervical deformity correction.METHODSA retrospective comparison of complication profiles between posterior-based SPO (Ames grade 2 SPO) and 3CO (Ames grade 5 opening wedge osteotomy and Ames grade 6 closing wedge osteotomy) was performed by examining a single-surgeon experience from 2011 to 2018. Patients of interest were individuals who had a cervical sagittal vertical axis (cSVA) > 4 cm and/or cervical kyphosis > 20° and who underwent corrective surgery for cervical deformity. Multivariate analysis was utilized.RESULTSA total of 95 patients were included: 49 who underwent 3CO and 46 who underwent SPO. Twelve of the SPO patients underwent an anterior release procedure. The patients’ mean age was 63.2 years, and 60.0% of the patients were female. All preoperative radiographic parameters showed significant correction postoperatively: cSVA (6.2 cm vs 4.5 cm [preoperative vs postoperative values], p < 0.001), cervical lordosis (6.8° [kyphosis] vs −7.5°, p < 0.001), and T1 slope (40.9° and 35.2°, p = 0.026). The overall complication rate was 37.9%, and postoperative neurological deficits were seen in 16.8% of patients. The surgical and medical complication rates were 17.9% and 23.2%, respectively. Overall, complication rates were higher in patients who underwent 3CO compared to those who underwent SPO, but this was not statistically significant (total complication rate 42.9% vs 32.6%, p = 0.304; surgical complication rate 18.4% vs 10.9%, p = 0.303; and new neurological deficit rate 20.4% vs 13.0%, p = 0.338). Medical complication rates were similar between the two groups (22.4% [3CO] vs 23.9% [SPO], p = 0.866). Independent risk factors for surgical complications included male sex (OR 10.88, p = 0.014), cSVA > 8 cm (OR 10.36, p = 0.037), and kyphosis > 20° (OR 9.48, p = 0.005). Combined anterior-posterior surgery was independently associated with higher odds of medical complications (OR 10.30, p = 0.011), and preoperative kyphosis > 20° was an independent risk factor for neurological deficits (OR 2.08, p = 0.011).CONCLUSIONSThere was no significant difference in complication rates between 3CO and SPO for cervicothoracic deformity correction, but absolute surgical and neurological complication rates for 3CO were higher. A preoperative cSVA > 8 cm was a risk factor for surgical complications, and kyphosis > 20° was a risk factor for both surgical and neurological complications. Additional studies are warranted on this topic.

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Anatomic Site-Specific Complication Rates for Central Venous Catheter Insertions

Journal of Intensive Care Medicine ◽

10.1177/0885066618795126 ◽

2018 ◽

Vol 35 (9) ◽

pp. 869-874 ◽

Cited By ~ 4

Author(s):

Jacob Bell ◽

Munish Goyal ◽

Sallie Long ◽

Anagha Kumar ◽

Joseph Friedrich ◽

...

Keyword(s):

Central Venous Catheter ◽

Complication Rate ◽

Venous Catheter ◽

Complication Rates ◽

Central Venous ◽

Site Specific ◽

Mechanical Complications ◽

Significant Difference ◽

Insertion Techniques ◽

Delayed Complications

Background: Central venous catheter (CVC) complication rates reflecting the application of modern insertion techniques to a clinically heterogeneous patient populations are needed to better understand procedural risk attributable to the 3 common anatomic insertion sites: internal jugular, subclavian, and femoral veins. We sought to define site-specific mechanical and duration-associated CVC complication rates across all hospital inpatients. Methods: A retrospective chart review was conducted over 9 months at Georgetown University Hospital and Washington Hospital Center. Peripherally inserted central catheters and tunneled or fluoroscopically placed CVC’s were excluded. Mechanical complications (retained guidewire, arterial injury, and pneumothorax) and duration-associated complications (deep vein thrombosis or pulmonary embolism, and central line-associated bloodstream infections) were identified. Results: In all, 1179 CVC insertions in 801 adult patients were analyzed. Approximately 32% of patients had multiple lines placed. Of 1179 CVCs, 73 total complications were recorded, giving a total rate of one or more complications occurring per CVC of 5.9%. There was no statistically significant difference between site-specific complications. A total of 19 mechanical complications were documented, with a 1.5% complication rate of one or more mechanical complications occurring. A total of 54 delayed complications were documented, with a 4.4% complication rate of 1 or more delayed complications occurring. There were no statistically significant differences between anatomic sites for either total mechanical or total delayed complications. Conclusions: These results suggest that site-specific CVC complication rates may be less common than previously reported. These data further inform on the safety of modern CVC insertion techniques across all patient populations and clinical settings.

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Effect of Travel Time and Distance on Outcomes in Total Ankle Arthroplasty

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00154 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0015

Author(s):

Kristin C. Caolo ◽

Scott J. Ellis ◽

Jonathan T. Deland ◽

Constantine A. Demetracopoulos

Keyword(s):

Travel Time ◽

Complication Rate ◽

High Volume ◽

Total Ankle Arthroplasty ◽

Complication Rates ◽

Linear Regression Models ◽

Ankle Arthroplasty ◽

Significant Difference ◽

Drive Time

Category: Ankle; Ankle Arthritis Introduction/Purpose: Surgeons who perform a higher volume of total ankle arthroplasty (TAA) are known to have decreased complication rates; evidence shows that low volume centers performing TAA have decreased survivorship when compared with high volume centers. Understanding differences in outcomes for patients traveling different distances for their TAA is important for future patients deciding where to travel for their surgery. No study has previously examined differences in outcomes of patients traveling different distances to a high volume center for their TAA. This study compares preoperative and postoperative PROMIS scores for patients undergoing total ankle arthroplasty who traveled less than and more than 50 miles for their TAA. We hypothesized that there would be no difference in outcome scores based on distance traveled or estimated drive time. Methods: This study is a single center retrospective review of 162 patients undergoing primary total ankle arthroplasty between January 2016 and December 2018. We collected the primary address as listed in the patient’s medical record and used the directions feature on Google Maps to estimate driving mileage and estimated driving time from the patient’s address to the hospital. To analyze the distance patients traveled, patients were divided into two groups: <50 miles traveled (n=91) and >50 miles traveled (n=71). To analyze the estimated drive time, patients were divided into two groups: <90 minutes (n=77), >90 minutes (n=85). We collected preoperative and most recent postoperative PROMIS scores for all patients. Differences in most recent post-operative PROMIS scores between distance groups and travel time groups were assessed using multivariable linear regression models, adjusting for the pre-operative score and follow-up time. Results: We found no significant difference in post-operative PROMIS scores between the two groups when analyzed for distance traveled or for estimated travel time after adjustment for pre-operative PROMIS score and follow-up time (Table 1). The average follow-up for all 162 patients was 1.49 years. Power analysis showed that with a sample size of 110 (55 in each group), we had 81% power to detect an effect size of 4. Patients saw an increase in their Physical Function scores and a decrease in their Pain Interference and Pain Intensity scores with postoperative scores better than population means (Table 1). Overall complication rate for the <50 miles group was 17.6%, 7.7% required surgery. The >50 miles group had an overall complication rate of 24.0%, 9.9% required surgery. Conclusion: Patients traveling further distances to a high volume orthopedic specialty hospital for their total ankle arthroplasty do not have different clinical outcomes than patients traveling shorter distances. This is particularly important for patients deciding where to have their total ankle arthroplasty surgery. Patients who travel further have the opportunity to be treated at a local academic center; however our results show that outcomes do not change when traveling further for total ankle arthroplasty. [Table: see text]

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Augmentation Mastopexy With Surgical Excision of the Lower Pole to Avoid Waterfall Deformity: A Surgical Technique and Nipple Areolar Complex Case Series

Plastic Surgery ◽

10.1177/2292550320933662 ◽

2020 ◽

pp. 229255032093366

Author(s):

Colin P. White ◽

Brian D. Peterson

Keyword(s):

Surgical Technique ◽

Breast Augmentation ◽

Capsular Contracture ◽

Case Series ◽

Senior Author ◽

Complex Case ◽

Silicone Implants ◽

Lower Pole ◽

Areolar Complex ◽

Augmentation Mastopexy

Purpose of this article is to demonstrate a way of avoiding the waterfall deformity in augmentation mastopexy patients. We will show a case series of results and explain how this technique gives satisfying aesthetic results for patients seeking breast augmentation who also require mastopexy. We will show how addressing the breast parenchyma on the lower pole via direct excision can give reliable results and avoids the waterfall deformity. The surgical technique used by the senior author combines the principles of breast augmentation, mastopexy, and breast reduction. We apply these principles during the initial single operation. Our goal is to achieve the best anatomical results for the patient. We describe 1538 consecutive patients whom underwent single-stage breast augmentation with mastopexy. All implants were submuscular with 12% being saline and 88% were silicone implants. Vertical mastopexies were performed in 8% and wise pattern incisions were used in 92%. There were no life-threatening complications such as deep vein thrombosis, pulmonary embolism, and so on. Tissue-related complications included wound infection (1%) and hematomas (1%). Implant-related complications included malposition or implant displacement 9% and capsular contracture 1%. Aesthetic complications included dystopia of NAC (4%) and volume asymmetries (10%). Revision surgery was tissue related (2%), implant related (3%), and aesthetic related (10%). There were no cases of waterfall deformity seen in the cohort. In conclusion, we believe that the technique detailed here is easy to do, uses principles already known of breast augmentation and reduction and gives consistent results with low reoperation rates.

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Prevention of Capsular Contracture with Montelukast After Insertion of Silicone Implants in Rabbits

Journal of Computational and Theoretical Nanoscience ◽

10.1166/jctn.2016.5762 ◽

2016 ◽

Vol 13 (10) ◽

pp. 7623-7627

Author(s):

Zhenyu Jin ◽

Ki Yong Hong ◽

Kyung Won Minn ◽

Hak Chang ◽

Ung Sik Jin

Keyword(s):

Breast Implant ◽

Capsular Contracture ◽

White Female ◽

Silicone Implants ◽

Control Group ◽

Tissue Samples ◽

Significant Difference ◽

Group A ◽

The Right ◽

Experimental Group

Capsular contracture is the most common complication after insertion of silicone implants during breast implant surgery. The discovery that myofibroblasts play an important role in the formation of hypertrophic scars led to the development of pharmacological drugs such as zafirlukast, which prevents capsular contracture by resisting the above mechanism. As a result, the author sought to investigate the effect of the anti-leukotriene montelukast on capsular contracture. Ten white female New Zealand rabbits, each weighing approximately 3 kg, were used as subjects. Through bilateral incision of the midback area, the prostheses were inserted on the subpanniculus carnosus plane. Once the silicone prostheses had been inserted, the right implant was injected with 10 mL of montelukast (10 µg/mL), and the left implant was injected with 10 mL of normal saline. Eight weeks after the procedure, the capsular pressure was measured via tonometry using a circular glass piece weighing 42.7 g. The tissue samples were then extracted, and their thicknesses were measured using hematoxylin-eosin stain and Masson trichrome stain. The average pressure was 4.23±0.99 mmHg in the control group and 3.71±0.51 mmHg in the experimental group, a statistically significant difference (p = 0.02). The average capsular thickness was 947.938±300 µm in the control group and 709.672±274 µm in the experimental group, a statistically significant difference (p = 0.028). The author confirmed that montelukast injections during silicone prosthesis insertion decreased the formation of capsular contracture.

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