Capsular Contracture In Augmentation Mammaplasty With Smooth Versus Textured Breast Implants:a Meta-Analysis

Objective:To analyze the incidence of capsular contracture in breast augmentation with smooth versus textured breast implants using Meta method.Methods:1.Inclusion and exclusion criteriaThe inclusion criteria:â‘ Clinical Controlled Trials had specifically compared textured with smooth breast implants.â‘¡All studies should detail research methods, number of cases and implant type.â‘¢ Selected trials must contain capsular contracture rates and original data.The exclusion criteria:Systematic reviews,case reports,review,surgical techniques,animal experiments,anatomy study and other types of literature without statistical data.2.Search strategyTerms as "breast augmentation", "breast implant", "smooth implant", "textured implant ","capsular contracture"were searched in databases such as MEDLINE, EMBASE, CBM, VIP and Cochrane Library.Documents about breast augmentation with textured and smooth implants were totally collected,and the data of these trials were extracted to obtain a pooled odds ratio of capsular contracture rates.Meta analyses were performed by RevMan 5.2 software to estimate the combined effect values.3.Data extractionThe studies identified through the search were strictly subjected to inclusion and exclusion criteria.The data abstraction form included fields for the first author,published year,treatment regimens, number of implants,implant type,follow-up time,number of capsular contractures and other complications.The procedure was performed independently by two authors and disagreement was resolved by discussion.4.Quality of studiesThe methodological quality for randomized controlled trials and non-randomized control trial was evaluated based on the Jadad scale and the Newcastle-Ottawa scale.5.Statistical AnalysisThe Review Manage Software 5.2 provided by Cochrane was used for statistical analysis.Subgroup will be analyzed according to the possible heterogeneity. When the test for heterogeneity could be done among the studies, (I2<50%) the fixed effect model was used ; in view of significant heterogeneity (I2>50%),random effect model was used for pooling.We calculated odds ratio for capsular contracture rates,and 95% confidence intervals to estimate the precision of treatment effects.Results:Eleven studies reporting outcomes of textured and smooth breast implants were used to estimate odds ratios of capsular contracture and confidence intervals. Textured implants group and smooth implant group occurred the risk of capsular contracture combined OR=0.32, 95%CI is [0.18,0.58], P=0.0002,the significant difference can be seen between the two groups.Textured implants group and smooth implant group occurred the risk of other complications combined OR=1.31,95%CI is [0.96,1.77], P>0.05,the difference was not statistically significant.Conclusions:Compared with smooth implants,textured implants significantly reduce the incidence of capsular contracture after breast augmentation.