Efficacy and Safety of Povidone-Iodine Irrigation in Reducing the Risk of Capsular Contracture in Aesthetic Breast Augmentation: A Systematic Review and Meta-Analysis

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Efficacy and Safety of Povidone-Iodine Irrigation in Reducing the Risk of Capsular Contracture in Aesthetic Breast Augmentation: A Systematic Review and Meta-Analysis

Yalanis et al., 2015 | Plast Reconstr Surg | Meta Analysis

Citation

Yalanis Georgia C, Liu En-Wei, Cheng Hsu-Tang. Efficacy and Safety of Povidone-Iodine Irrigation in Reducing the Risk of Capsular Contracture in Aesthetic Breast Augmentation: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2015-Oct;136(4):687-698. doi:10.1097/PRS.0000000000001576

Abstract

BACKGROUND: Capsular contracture is common and distressing after aesthetic breast augmentation. The precise cause of capsular contracture is not well established. This systematic review investigates current available evidence regarding perioperative povidone-iodine irrigation safety and efficacy in reducing capsular contracture. METHODS: PubMed/MEDLINE, Embase, and Scopus databases were searched for publications through December of 2014. Studies with the following criteria were included: (1) primary breast augmentation with implants; (2) perioperative povidone-iodine use; and (3) documentation of capsular contracture. Our primary outcome was incidence of Baker class III/IV capsular contracture. The methodologic quality of included studies was assessed independently. Trials were meta-analyzed to obtain a pooled odds ratio describing the effect of povidone-iodine irrigation on Baker class III/IV capsular contracture. RESULTS: Nine studies with a total of 5153 patients undergoing aesthetic breast augmentation with implants were included. Only three comparative studies achieved high methodologic quality. The meta-analysis included four studies, with 1191 patients receiving povidone-iodine irrigation and 595 patients receiving saline irrigation. The meta-analysis favored povidone-iodine irrigation for decreasing Baker class III/IV capsular contracture (2.7 percent versus 8.9 percent; OR, 0.30; 95 percent CI, 0.18 to 0.50; p < 0.00001; I = 0 percent). The reported implant rupture rates for both saline implants and silicone implants were less than 1 percent. CONCLUSIONS: Perioperative povidone-iodine irrigation reduces Baker class III/IV capsular contracture and is not associated with implant rupture. Low methodologic quality of included studies limits recommendations for perioperative povidone-iodine irrigation as the standard of practice. Additional high-quality trials are warranted to corroborate the findings of this meta-analysis. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Key Findings

Nine studies with a total of 5153 patients undergoing aesthetic breast augmentation with implants were included. Only three comparative studies achieved high methodologic quality. The meta-analysis included four studies, with 1191 patients receiving povidone-iodine irrigation and 595 patients receiving saline irrigation. The meta-analysis favored povidone-iodine irrigation for decreasing Baker class III/IV capsular contracture (2.7 percent versus 8.9 percent; OR, 0.30; 95 percent CI, 0.18 to 0.5

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 5153
Age Range See abstract
Condition stress

MeSH Terms

  • Anti-Infective Agents, Local
  • Breast Implantation
  • Female
  • Humans
  • Implant Capsular Contracture
  • Incidence
  • Odds Ratio
  • Povidone-Iodine
  • Therapeutic Irrigation
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09