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The Value of Capsule Thickness on Breast Ultrasound as an Indicator of the Severity of Capsular Contracture and Its Correlation with the Baker Classification

  • Original Article
  • Breast Surgery
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Abstract

Background

We conducted this study to explore the value of the capsule thickness as an indicator of the severity of capsular contracture (CC) alternatively to the Baker classification system in patients who were treated with an implant-based augmentation mammaplasty.

Methods

A total of 117 eligible patients (202 breasts) were included in the current study. We measured the capsule thickness using ultrasound and histologic examination in association with the Baker grades I, II, III and IV. Then, we analysed agreement of the capsule thickness between the two methods using an intra-correlation coefficient (ICC 2,1) with 95% confidence intervals (CIs). The CC of Baker grades II, III and IV (105 breasts), for which the capsule thickness could be measured using US, served as Model 1. Moreover, Model 1 including the CC of Baker grades I (97 breasts) served as Model 2.

Results

The capsule thickness was measured as 0.58 ± 0.11 (0.4–0.8) mm, 1.07 ± 0.16 (0.8–1.31) mm and 1.89 ± 0.55 (1–4.1) mm on ultrasound in association with Baker grades II, III and IV, respectively. In addition, it was also measured as 0.28 ± 0.07 (0.09–0.41) mm, 0.58 ± 0.08 (0.42–0.75) mm, 1.06 ± 0.14 (0.79–1.34) mm and 2.13 ± 1.14 (1.38–6.98) mm on histologic examination in association with Baker grades I, II, III and IV, respectively. In Model 1 and 2, the ICC was calculated as 0.942 (95%CI 0.914–0.961) and 0.955 (95%CI 0.940–0.966), respectively. The cut-off values between the Baker grades I–II, II–III and III–IV were calculated as 0. mm, 0.8 mm and 1.2 mm, respectively.

Conclusions

In conclusion, the capsule thickness might be used as an indicator of the severity of CC alternatively to the Baker classification system. But further studies are warranted to establish our results.

Level of Evidence IV

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Funding

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Authors and Affiliations

  1. The W Clinic, 9F Kukdong B/D, 596 Gangnam-daero, Gangnam-gu, Seoul, 06626, Korea

    Jae Hong Kim

  2. Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

    Sang Eun Nam

  3. BBC Plastic Surgery Clinic, Changwon, Korea

    Jung Youp Sung

  4. Department of Breast Surgery, Gwangju Suwan Hospital, Gwangju, Korea

    Keun Yeong Song

  5. Yang Hospital, Namyangju, Korea

    Bum Sik Bang

  6. Vievis NAMUH Hospital, Seoul, Korea

    Eun Kyoung Lee

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  1. Jae Hong Kim
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Correspondence to Jae Hong Kim.

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The authors have no conflicts of interest to disclose.

Ethical Approval

The current study was conducted in compliance with the relevant ethics guidelines; all procedures performed in it were in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Written informed consent was waived due to the retrospective nature of the current study.

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Kim, J.H., Nam, S.E., Sung, J.Y. et al. The Value of Capsule Thickness on Breast Ultrasound as an Indicator of the Severity of Capsular Contracture and Its Correlation with the Baker Classification. Aesth Plast Surg 46, 621–629 (2022). https://doi.org/10.1007/s00266-021-02544-5

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  • DOI: https://doi.org/10.1007/s00266-021-02544-5

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