Breast augmentation, capsular contracture and Singulair were the subject of a recent article in the Aesthetic Surgery Journal that cites a study that shows that Singulair improves capsular contracture in women with breast implants. 19 patients with breast implants were treated. 17 patients presented with capsular contracture from a variety of breast operations. Two patients who had a history of recurrent capsular contracture were given the medication prophylactically. 11% of the patients became worse 16% of patients had no change 26% improved 37% completely improved and 11% were prevented fromgetting capsular contracture. The study showed that Singulair improves capsular contracture in women with breast implants. It appeared to have better results in milder contracture versus more severe contracture. Singulars well-tolerated with minimal side effects.

This corresponds with what I’ve been doing for the last several years. However now there is a published study that shows that Singulair works. This doesn’t make it work any better but it does further legitimize the off-label use.

As mentioned before, many different things can cause contracture after breast implants. Factors like bacterial contamination and hematoma. These can prolong the inflammatory response. A colleague and friend of mine, Dr.Schlesinger, discovered that a drug called Accolate, which is an anti-inflammatory asthma drug, worked in improving capsular contracture and published this. However it was discovered later on that Accolate had a very small incidents of extremely severe complications including hepatitis liver failure and death. This led to the abandonment of the use of Accolate despite the fact that it worked very well. Cingular is a similar type of drug. It is what is called a leukotriene inhibitor. These are factors that are thought to be responsible for capsular contracture.

This particular study on women with breast implants confirms what I have personally noted over the last several years. Cingular can help reverse capsular contracture when it is caught early and just starting. It can also help prevent recurrence. However, if someone comes in with established capsular contracture or extremely firm contracture it has little effect. The repair of very firm contracture is still a surgical procedure

Capsular contracture still continues to be an annoying and expensive problem in plastic surgery. By using techniques like the no touch Keller Funnel while placing breast implants during breast augmentation, see my previous blog about the Keller Funnel, IV antibiotics and antibiotic irrigation weekendreduce the incidence of contracture. However it is good to know that Singulair has been shown to be effective. In my own practice I combine it with cold laser to make it even more effective and see about 4 out of 5 people respond to the combination.