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Open Access
CC BY 4.0 · Arch Plast Surg 2025; 52(04): 217-224
DOI: 10.1055/a-2620-3350
Breast/Trunk
Original Article

Assessment of Capsular Contracture Based on Morphological Change of Breast Implant Using Computed Tomography

Won Seok Oh 
1   Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea (the Republic of)
,
Seung Hoon Lee 
1   Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea (the Republic of)
,
Jae Woo Lee 
1   Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea (the Republic of)
,
Jung Yeol Seo 
1   Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea (the Republic of)
,
Choong Rak Kim 
2   Department of Statistics, Pusan National University, Busan, Korea (the Republic of)
,
Su Bong Nam 
1   Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea (the Republic of)
› Author Affiliations
Funding This work was supported by a 2-year Research Grant to Pusan National University.
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Abstract

Background

Capsular contracture is a common complication following implant-based breast reconstruction. Current assessment methods, primarily relying on the subjective Baker grading system, lack objectivity and quantitative data, which hinders large-scale studies and the development of treatment guidelines. To solve these problems, we conducted a study using computed tomography (CT) scans to quantitatively evaluate morphological changes in breast implants associated with capsular contracture.

Methods

We enrolled 94 patients who underwent breast reconstruction using implants and underwent periodic chest CT scans. We categorized them into two groups: Baker grade I or II (n = 72) and Baker grade III or IV (n = 22). We analyzed the CT scans to assess changes in the implant base and projection.

Results

In the Baker grade III or IV groups, it was confirmed that the ratio of projection to base increased after capsular contracture compared with before contracture. On the other hand, there was no significant change in the ratio of projection to base in the Baker grade I or II groups.

Conclusion

This study highlights the potential of CT scans as a reproducible method for evaluating capsular contracture. The ratio of projection to base could serve as a new quantitative index alongside the Baker grades for clinical assessment, treatment planning, and research on capsular contracture. When comparing the ratio of projection to base before and after capsular contracture, if the ratio of projection to base increases by more than 1.233 times, it can be considered Baker grade III or IV.

Keywords

breast implant - capsular contracture - Computed tomography

Note

This article was presented at the 13th Research and Reconstruction Forum on May 12, 2023, in Korea.


Ethical Approval

The study was approved by the Pusan National University Yangsan Hospital (IRB No. 55-2023-043) and performed in accordance with the principles of the Declaration of Helsinki.


Patient Consent

The patients provided written informed consent for the publication and use of their images.


Authors' Contributions

Conceptualization: S.B.N., W.S.O.

Data curation: S.H.L., J.Y.S.

Formal analysis: S.H.L., C.R.K.

Methodology: W.S.O., J.W.L.

Project administration: W.S.O., J.W.L.

Visualization: S.H.L., J.Y.S.

Writing—original draft: W.S.O., S.H.L.

Writing—review and editing: W.S.O., S.B.N.

Supervision: W.S.O., S.B.N.

All authors read and approved the final manuscript.




Publication History

Received: 03 October 2023

Accepted: 23 March 2025

Article published online:
23 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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