The correction of capsular XXXX by conversion to "dual-plane" positioning: technique and outcomes.

@entity1 @entity1346 @entity5748 @entity1159
Little has been published regarding the treatment of @entity1 with long-established capsular @entity1159 after previous submuscular or subglandular breast augmentation. This study reviews 7 years of experience in treating established capsular @entity1159 after augmentation mammaplasty by relocating implants to the "dual-plane" or partly subpectoral position. A retrospective chart review was performed on all @entity1 who were treated for capsular @entity1159 using this technique between 1993 and 1999. Data collected included the date of the original augmentation, the original implant location, date of revision and type of implant used, length of follow-up, outcome, and any ensuing complications. Different surgical techniques were used, depending on whether the prior implant was located in a subglandular or submuscular plane. All @entity1 had revisions such that their implants were relocated to a dual plane, with the superior two thirds or so of the implant located beneath the pectoralis major muscle and the inferior one third located subglandularly. Of 85 @entity1 reviewed, 54 had their original implants in a submuscular position and 31 had their initial augmentation in a subglandular position. Of the 54 @entity1 whose implants were initially submuscular, 23 @entity1 (43 percent) had @entity1346 gel implants, 15 @entity1 (28 percent) had double-lumen implants, and the remaining 16 @entity1 (30 percent) had saline implants. Of the 31 @entity1 whose implants were initially subglandular, 20 @entity1 (65 percent) had @entity1346 gel implants, three @entity1 (10 percent) had double-lumen implants, and the remaining eight @entity1 (26 percent) had saline implants. Fifty-one @entity1 (60 percent) had replacement with saline implants (37 smooth saline, 14 textured saline), whereas 34 (40 percent) had @entity1346 gel implants (seven smooth gel, 27 textured gel). The average time from previous augmentation to revision was 9 years 9 months. The average follow-up time after conversion to the @entity5748 was 11.5 months. Only three of 85 @entity1 required reoperation for complications, all of which involved some degree of implant malposition. Of @entity1 converted to the dual plane, 98 percent were free of capsular @entity1159 and were Baker class I at follow-up, whereas 2 percent were judged as Baker class II. There were no Baker level III or IV @entity1159 at follow-up. The dual-plane method of breast augmentation has proved to be an effective technique for correcting established capsular @entity1159 after previous augmentation mammaplasty. This technique appears to be effective when performed with either @entity1346 or saline-filled implants.
