Capsular contracture is a challenging problem for plastic surgeons despite advances in surgical technique. Breast pocket irrigation decreases bacterial bioburden. Studies have shown hypochlorous acid (PhaseOne Health, Nashville, TN) to effectively penetrate and disrupt biofilms; however, there is limited clinical data regarding this irrigation in breast augmentation.
To investigate the effects of hypochlorous acid (HOCl) pocket irrigation in revision breast augmentation by evaluating rates of capsular contracture recurrence, infection, and allergic reactions.
We performed an IRB-approved retrospective chart review of revision breast augmentation cases for Baker grade III/IV capsular contractures using HOCl for pocket irrigation. Data was obtained from three board-certified plastic surgeons.
There were 135 breasts in 71 patients included in the study. Age range was 27-77 years, with a mean of 53.7. Follow-up ranged from 12-41 months, with a mean of 20.2 months. There were two unilateral Baker grade III/IV recurrences at 13 months and one bilateral Baker grade II recurrence at 3 months postoperative. There were no infections or allergic reactions. Overall Baker grade III/IV capsular contracture recurrence rate was zero at 12 months and 1.5% at 15 months.
Breast pocket irrigation decreases bioburden which may influence capsular contracture recurrence. We evaluated three varied applications of HOCl in revision aesthetic breast surgery and found a low capsular contracture recurrence rate and no adverse reactions. We plan to report our findings with HOCl in primary breast augmentation in the future and other studies being conducted on the efficacy of HOCl in aesthetic surgery.

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