The use of botulinum toxin type A in the conservative treatment of capsular contracture grades II—III according to Baker

Capsular contracture is one of the most common complications in reconstructive surgery for breast cancer. After the implant is installed, a capsule is formed, which is a normal protective reaction. When capsular contracture occurs, the capsule thickens and contracts, thereby compressing the implant, leading to deformation, hardening, and pain in the reconstructed breast. Conservative treatment with botulinum toxin type A can reduce these symptoms and improve quality of life. Objective. To determine indications for conservative treatment for capsular contracture grades II and III. Material and methods. The study included 42 patients (study group) with capsular contracture grades II—III according to Baker after reconstructive surgery who underwent conservative treatment with botulinum toxin type A, as well as 42 patients (control group) who underwent surgical treatment without the use of botulinum toxin type A. Results. The study included patients with a mean age of 47.8±6.5 years. Before botulinum toxin type A administration, capsule thickness was determined using ultrasound and averaged 1.82±0.53 mm in Group 1 and 1.8±0.6 mm in Group 2 before surgery. The study noted a longer period of capsular contracture development in Group 2. Patients who received botulinum toxin type A demonstrated a positive effect that persisted 6 months after administration, with the average capsule thickness being 1.46±0.43 mm. The use of botulinum toxin made it possible to delay the need for surgical intervention by an average of 1.2 years. Conclusion. Botulinum toxin type A injections may be used to reduce symptoms and slow the time it takes for capsular contracture to progress.