Have surgeons seen an increased rate of capsular contracture with Motiva implants placed subglandularly?

Question

Motiva implants are touted as being especially safe, including as having a low rate of capsular contracture. However, none of the published studies break down capsular contracture rates by the plane of implant placement. Additionally, the vast majority of patients in these studies (over 97% of primary augmentation patients) had their implants placed dual plane or submuscularly. With the current interest in minimally invasive breast implant procedures where the implant is placed subglandularly (Preserve), have surgeons seen an increased rate of capsular contracture with Motiva implants placed subglandularly?

Mert Demirel, MD · Answer

This is a very good question. Motiva implants have reported low capsular contracture rates in published studies, but you are correct that much of the available data includes a high percentage of submuscular or dual-plane placement, so the evidence is not as strong for purely subglandular placement.
In general, subglandular placement has historically been associated with a higher capsular contracture risk compared with submuscular or dual-plane placement, regardless of implant brand. That does not mean every subglandular implant will develop contracture, but the plane is one of the factors that can influence risk.
Motiva’s surface and gel technology may reduce some risks, but it does not completely eliminate the biological factors that contribute to capsular contracture. Bacterial contamination, biofilm, bleeding, inflammation, implant size, tissue coverage, prior surgery, and pocket trauma all still matter.
With newer “Preserve” or minimally invasive subglandular techniques, long-term independent data is still limited. Some surgeons may be seeing good early results, but early experience is not the same as long-term evidence over many years.
My advice would be to ask your surgeon for their own capsular contracture rate specifically with Motiva in the subglandular plane, not just Motiva overall. Also ask why subglandular placement is being recommended for your anatomy, how they minimize contamination, whether your tissue coverage is adequate, and what the revision plan would be if contracture occurs. A low-risk implant does not make the pocket choice irrelevant.

John L. Burns Jr., MD · Answer

Motiva is unique due to the 4 micron silk surface that defines their implants.  This surface is well researched and the data supports the fact the the incidence of capsular contracture is much less with these implants which allows them to be safely used in the sub glandular or subfascial plane which is popular with athletic women who wish to avoid animation deformity.

Have surgeons seen an increased rate of capsular contracture with Motiva implants placed subglandularly?

Answers (2)

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