Ultrasound Elastography and Tonometry as Predictive Tools for Capsular Contracture After Breast Implant Surgery: Over a 12-Month Prospective Study

<b>Background/Objectives</b>: Capsular contracture remains the most common complication after breast augmentation. The Baker score is a classical, yet subjective method to assess the contracture, therefore more objective and reproducible measures are necessary to not only evaluate but also to predict a capsule formation. The aim of the prospective study was to assess the predictive value of sonoelastography, tonometry and physical examination at different time points after the surgery and with association with Baker score, since this early period is considered critical for the initiation of capsular formation. <b>Methods</b>: 28 patients (range of age 21.0-40.0) after breast augmentation completed the study protocol. A total of 56 breasts underwent clinical (modified Baker score), tonometric, and elastographic evaluation before surgery, on postoperative days 7 and 14, and after one year. Measurements were taken at the boundaries of the four breast quadrants and included adipose, glandular, muscular and fascial tissues. <b>Results</b>: At long-term follow-up, tonometric and elastographic values were lower than on postoperative days 7 and 14. Early measurements in certain quadrants and tissue regions showed some association with Baker scores at one year. All tissues increased in stiffness postoperatively and remained stiffer at the 1-year follow-up. No significant differences in tissue stiffness were observed between days 7 and 14, except for higher values in adipose tissue in the inner quadrant and lower values at the peri-implant region in the outer quadrant. <b>Conclusions</b>: Sonoelastography is a precise and objective tool for detecting capsular changes after breast augmentation and may improve early prediction of contracture.