Reduced capsular contracture with smooth and textured breast implants following submuscular mammoplasty: systematic literature review.

Capsular contracture is common in breast augmentation and reconstruction surgery. The present systematic review discusses the safety of textured and smooth implants in the submuscular position.  A literature search was conducted on PubMed and EMBASE from inception until June 2020. The primary outcome was reduction of capsular contracture (Baker grade); others included time of capsular contracture onset, implant position/rupture rate/surface, hematoma/seroma risk, surgeon assessment and patient satisfaction. A total of 7731 patients were included from six publications. The overall risk rate for capsular contracture increased from 7.6 to 25% in 10 years. The capsular contracture rates in textured and smooth implants were 3-14% and 6-20%, respectively, and no significant difference between implants was observed when the implants were placed submuscularly. Submuscular placement and textured implants also reduced the incidence of other complications. This systematic review suggests that appropriate placement reduces capsular contracture rate, irrespective of implant surface.