Evidence map›Paper›PMID 34231019›Full record

SynthesisAesthetic plastic surgery2022

Breast Implant-associated Double Capsules: What Do We Know So Far? A Systematic Review of the Literature.

Serge Zogheib, Cyril Hanna, Bechara Daou, Georges Mjaess, Marwan Nasr

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Aesthetic plastic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Serge Zogheib *Department of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Faculty of Medicine, Hotel Dieu de France University Hospital, Saint Joseph University, Damascus street, Achrafieh, P.O. Box:17-5208, Beirut, Lebanon. zogheibserge@gmail.com.ORCID 0000-0002-6603-0291
Cyril Hanna *Department of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Faculty of Medicine, Hotel Dieu de France University Hospital, Saint Joseph University, Damascus street, Achrafieh, P.O. Box:17-5208, Beirut, Lebanon.
Bechara DaouDepartment of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Faculty of Medicine, Hotel Dieu de France University Hospital, Saint Joseph University, Damascus street, Achrafieh, P.O. Box:17-5208, Beirut, Lebanon.
Georges MjaessDepartment of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Faculty of Medicine, Hotel Dieu de France University Hospital, Saint Joseph University, Damascus street, Achrafieh, P.O. Box:17-5208, Beirut, Lebanon.
Marwan NasrDepartment of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Faculty of Medicine, Hotel Dieu de France University Hospital, Saint Joseph University, Damascus street, Achrafieh, P.O. Box:17-5208, Beirut, Lebanon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA double capsule is a recently described rare occurrence following breast implant placement in which an inner capsule envelope totally or partially adheres to the implant surface while a distinct outer capsule adheres to surrounding tissues, with an intercapsular space developing between the two. The objective of this study is to review all available literature related to formation of double capsules and propose a treatment algorithm. METHODS AND MATERIALS: A systematic review of the literature was conducted using Embase, Medline, and Cochrane databases. Articles reporting management of breast implant-associated double capsules were included in this review.

resultsA total of 9 studies (68 implants) were included in the review. 94.1% of double capsules occurred with textured Biocell shaped and round implants independently from implant pocket (p value=0.64). In all cases, double capsules were diagnosed fortuitously intra-operatively for another surgical indication. Capsular contracture was present in 50% of double capsules patients and was the most common indication for secondary breast surgery, 81.5% of which being clinically evident (p value<0.001). Treatment consisted in 84.4% in an inner capsulectomy with smooth implants exchange, and management of the outer capsule as per the capsular contracture algorithm.

conclusionDouble capsule formation is caused by delamination of a tight adhering capsule to a textured implant surface into two layers and continuous micro-shearing forces, and the probable contribution of bacterial biofilm. The only treatment reported so far includes inner with or without outer capsulectomy with smooth implant exchange. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Indexed as

Breast ImplantationBreast ImplantsMammaplastyCapsulesHumansImplant Capsular ContractureMastectomyCapsulesBreast implantDouble capsuleExplantation

Identifiers

PMID34231019

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.