Pilot Study: Vancomycin Calcium Sulfate Beads in the Prevention of Recurrent Capsular Contracture of Breast Implants.

BACKGROUND

Prevention and management of capsular contracture of the breast remain the most challenging complications after breast augmentation and reconstruction. The use of resorbable calcium sulfate beads containing antibiotics within the breast pocket has been found to reduce implant extrusion from infections. No previous studies have determined whether biofilm-related recurrent capsular contracture (RCC) of the breast can be reduced using similar antibiotic beads at the time of surgery.

METHODS

A retrospective case series study by 1 surgeon, conducted between 2006 and 2025, was performed to determine whether placing calcium sulfate beads with either 500 mg or 1 g of vancomycin within a breast pocket, versus no beads, following capsulectomy and implant exchange could prevent RCC. Thirty-eight patients underwent 40 procedures involving 57 breasts. RCC was defined as Spear-Baker grade III or IV.

RESULTS

The use of antibiotic beads was associated with a significant reduction in RCC (P < 0.001). Patients without beads, considering all other factors, had 15 times greater odds of developing RCC. This risk was reduced to 8 times greater odds when accounting for length of follow-up.

CONCLUSIONS

This pilot study supports the use of calcium sulfate beads in combination with vancomycin for the prevention of RCC.