Efficacy of Bovine Whey Protein Extract in Preventing Capsular Contracture After Breast Augmentation

牛乳清蛋白萃取物應用於隆乳手術後莢膜攣縮之預防成效

胡桂嘉(Kuei-Chia Hu) ； 蔡明峰(Ming-Feng Tsai) ； 姚文騰(Wen-Teng Yao) ； 游家孟(Chia-Meng Yu) ； 董光義(Kwang-Yi Tung) ； 黃文成(Wen-Chen Huang) ； 陳昱帆(Yu-Fan Chen) ； 李安莉(An-Li Lee)

《臺灣整形外科醫學會雜誌》 30卷4期 (2021/12) Pp. 203-214

摘要

Background: Capsular contracture (CC) is a common complication of breast augmentation using implants, likely due to inflammation. Bovine whey protein extract (BWPE), enriched in transforming growth factor beta (TGF-β), has been shown to reduce inflammation. It is a common practice for women to take BWPE after breast augmentation, but there is no data about the efficacy of BWPE in preventing CC. Aim and Objectives: To assess if BWPE can prevent the occurrence of CC after breast augmentation, we compared the outcome of women who take BWPE or not after the surgery. Materials and Methods: A chart review study was conducted for women who underwent breast augmentation in our hospital from January 2011 to August 2019. CC severity was graded by Baker classification. All information, including the use of BWPE, occurrence and severity of CC, and other complications, were obtained from the electronic health records. Multivariate logistic regression analysis was performed to analyze the results. Results: Data were collected from 23 women who took BWPE and 23 who did not (non- BWPE). The two groups did not differ in mean age, BMI, or the indication for the surgery. After a mean follow-up period of 15 (non-BWPE) and 18 (BWPE) months, 65% of non-BWPE women and 13% of BWPE women developed any CC (p = 0.001). Six women in the non-BWPE group had complications including seroma and hematoma, and all of them developed CC; excluding these six cases, the protective effect of BWBE from developing CC was still significant (p = 0.01). There was no serious adverse event associated with the use of BWPE. Conclusion: Our findings reveal that BWPE intake after breast augmentation is likely to prevent the occurrence of CC, and is well tolerated.

關鍵字

capsular contracture ； breast augmentation ； implants ； bovine whey protein extract ； TGF-β

並列摘要

背景：莢膜攣縮是植體隆乳手術後的常見併發症，過去文獻多歸因其源自發炎反應。其症狀及後續治療常對病患造成生理及心理的影響，因此預防便成為重要目標。牛乳清蛋白萃取物萃取自母牛初乳，富含乙型轉化生長因子，研究顯示可抑制發炎。臨床上顯示牛乳清蛋白萃取物能預防莢膜攣縮，但目前並無系統性研究。目的及目標：藉由比較有無服用牛乳清蛋白萃取物的患者之術後結果，來評估其對植體隆乳手術後莢膜攣縮的預防成效。材料及方法：系統性回顧2011年1月至2019年8月之間，於馬偕紀念醫院接受植體隆乳手術之患者之電子病歷，針對術後莢膜攣縮的嚴重度分級。並對患者之基本資訊、有無服用牛乳清蛋白萃取物、併發症、副作用進行多項式邏輯迴歸統計分析。結果：研究收錄46位患者，23位有服用牛乳清蛋白萃取物，另外23位患者則無。兩組患者並無年齡、BMI或手術適應症之差異。在平均追蹤15及18個月後，65%未服用的患者及13%有服用的患者出現程度不等的莢膜攣縮，統計分析後有意義。六位未服用萃取物的患者出現術後併發症包括血清腫及血腫，且後續都出現莢膜攣縮；在排除掉這六位病人後，萃取物預防莢膜攣縮之成效仍具有統計意義。所有服用牛乳清蛋白萃取物的患者都沒有出現副作用。結論：牛乳清蛋白萃取物對於植體隆乳手術後莢膜攣縮有良好的預防成效，而且耐受性良好，是一個低併發症的好選擇。