Abstract
Background
While there are many indications for periprosthetic breast capsulectomy, heightened public attention surrounding breast implant illness has resulted in increased rates of capsulectomy.
Objectives
This study aims to identify the incidence of major complications and risk factors associated with capsulectomy.
Methods
Using a prospectively enrolled cosmetic surgery insurance database, CosmetAssure (Birmingham, AL, USA), patients undergoing capsulectomy between January 2, 2017 and July 31, 2019 were identified. Outcomes measured included the occurrence of and risk factors for major complication(s) necessitating an emergency department visit, hospitalization, or reoperation within 45 postoperative days.
Results
Among 76,128 patients evaluated, 3048 (4.0%) underwent capsulectomy. There was a significant increase in number of capsulectomies following January 6, 2019 (2.7/day vs 5.2/day, p<0.05). Capsulectomy patients had more likely to have any complication and specifically hematoma than those undergoing breast implant removal or replacement without capsulectomy (2.8% vs 1.9% and 1.6% vs 0.9%, respectively, p<0.05). Eighty-four (2.8%) developed at least one complication. The most common complications included hematoma (1.6%) followed by infection (0.5%). ASA class III/IV was an independent risk factor for any complication and BMI ≥30 and office-based surgical suites were risk factors for infection.
Conclusions
There is a growing number of capsulectomies being performed. The most common major complication is hematoma. Patients undergoing capsulectomy confer a higher complication rate compared to those undergoing breast implant removal or replacement without capsulectomy. Patients should be counseled regarding the potential for major complications.