Popcorn Capsulorrhaphy in Revision Aesthetic 2018, 1–12 Breast Surgery

Bradley Calobrace, MD, FACS; Chet Mays, MD ; Ryan Wilson, MD; and Ryan Wermeling, MD

Abstract 

Background: Control of the pocket in revisional breast surgery can be technically challenging and unpredictable. A capsulorrhaphy technique has been utilized in altering capsules in secondary aesthetic breast surgery.

Objectives: The authors sought to determine the effectiveness of popcorn capsulorrhaphy in revisional breast surgery.

Methods: A retrospective chart review of revisional breast cases utilizing popcorn capsulorrhaphy was conducted between September 2015 andAugust 2017. Only aesthetic breast cases were included. Data were collected for 149 patients.

Results: One hundred forty-nine patients representing 266 breasts were operated on. The average patient age was 42 years and the mean body mass index was 24.2 kg/m2. The average time from their original surgery to the popcorn capsulorrhaphy secondary procedure was 9.3 years. Indications for capsulorrhaphy included malposition in 163 breasts (61.3%), implant positioning for breast ptosis in 34 breasts (12.8%), pocket adjustment for implant size change in 49 breasts (18.4%), and postexplantation pocket reduction in 20 breasts (7.5%). Of the 266 implants, 145 (54.5%) were smooth, 101 (38%) textured, and 20 (7.5%) were explanted. The average original implant size was 405 cc and the average size placed at the time of capsulorrhaphy was 422 cc. Two hundred thirty-six (88.7%) were in a submuscular pocket and 30 (11.3%) were subglandular. The total number of complications was 39 (14.7%), and 16 (6%) required some type of operative revision.

Conclusions: Popcorn capsulorrhaphy can provide pocket control and stability with low complication and revision rates. The addition of a mesh or biologic at the time of popcorn capsulorrhaphy can further lower the complication and revision rates.

 

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