PhaseOne Hypochlorous Acid is Effective for Preventing Capsular Contracture and Infection in Primary Breast Augmentation

BACKGROUND: Choice of breast pocket irrigation for implants remains highly contentious in the current literature. Several studies have demonstrated that 0.025% hypochlorous acid (HOCl) is highly effective for preventing infection and capsular contracture, without risk for cytotoxicity nor allergic reactions. This present study is the first to report outcomes of primary breast augmentation using HOCL irrigation. OBJECTIVES: To compare capsular contracture rates after primary breast augmentation of HOCL to alternative irrigation solutions. METHODS: A retrospective review was conducted on patients who underwent primary breast augmentation between January 2018 and December 2019. Four main groups of irrigation were compared: HOCL, antibiotic with povidone iodine (PI), antibiotic alone, chlorhexidine (CHG). Outcomes of interest were capsular contracture, mild infection (resolved with oral antibiotics), and severe infection (requiring explantation). RESULTS: A total of 243 patients (486 breasts) were included with an average follow-up of 13 months. Capsular contracture rates were as follows: 0% (HOCL), 2.3% (antibiotic solution with PI), 1.7% (antibiotic alone), and 0% (CHG). Severe infection rates were 1.2% (HOCl), 0.4% (antibiotic with PI), 0% (antibiotic alone), and 1.2% (CHG). Mild infection rates were 0% (HOCL), 0.5% (antibiotic with PI), 1.7% (antibiotic without PI), and 0% (CHG). CONCLUSIONS: Compared to standard irrigation techniques, PhaseOne 0.025% HOCL is equally effective in preventing capsular contracture and infection in primary breast augmentation.