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Melvin Westreich, MD
Wayne State University Detroit

JAMA. 1978;239(5):401.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Recently I have noticed hand and forearm injuries sustained by plastic surgeons who perform external capsulotomy for spherical contracture of the breast. This represents an unusual work-related injury.

Spherical contracture of the breast can occur following augmentation mammoplasty using silicone implants when the capsule surrounding the implant contracts forcing the flat, supple prosthesis into a firm, hard sphere to attain the smallest surface area.¹ These contractures can be quite distressing and uncomfortable to the patient, and until the external capsulotomy was developed, they did not have an adequate treatment.

External capsulotomy for spherical breast contracture has become a common office practice for the busy plastic surgeon. The technique and the complications seen in the patient have been well described.²

Three well-established local plastic surgeons have noted fairly severe upper-extremity musculoskeletal injuries following repeated use of the procedure. None of these physicians have required surgical repair . . . [Full Text PDF of this Article]

Footnotes
Edited by John D. Archer, MD, Senior Editor.

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