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Cirurgia de Revisão de Contratura Capsular



Revisão de Contratura Capsular.

          A contratura capsular é o motivo mais comum da cirurgia de revisão de mama. O tecido ao redor do implante fica mais firme, como uma reação do sistema imunológico ao material estranho.

Existem 4 graus de contratura capsular pelo sistema de classificação de Baker (1)

Grau I A mama é normalmente macia e parece natural em tamanho e forma.

Grau II A mama é pouco firme, mas parece normal.

Grau III A mama é firme, mas parece anormal.

Grau IV A mama é dura, dolorosa ao toque e parece anormal.

Grau III-IV Precisa de cirurgia de revisão

 

Por que uma contratura capsular acontece?

As causas mais comuns de contratura capsular vêm de:

1. Técnica de cirurgião, contaminação, hematoma
2. Material do implante; qualidade do implante varia, dependendo do material e dos fabricantes
3. Pacientes; o sistema imunológico e a reação ao material estranho em cada paciente

 

Como corrigir isso?

1. Capsulotomia, o cirurgião irá expandir a cápsula. Esta técnica está disponível para Grau 1 e 2
2. Capsulectomia, o cirurgião removerá a cápsula que foi coberta pelo implante para Grau 3 - 4
O incidente de taxa de recorrência, após capsulectomia e colocação de novo implante, é de 30,7%, relatado por Caffee(2)

 

Reference

1. https://en.wikipedia.org/wiki/Capsular_contracture
2. https://journals.lww.com/prsgo/FullText/2016/10000/ Open_Capsulotomy ___An_Effective_but_Overlooked.7.aspx


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