Subfascial Breast Augmentation: A Systematic Review and Meta-Analysis of Capsular Contracture

Why this matters

Subfascial breast augmentation is a technique originally developed to reduce the risks of capsular contracture while decreasing the postoperative pain associated with subpectoral augmentation. This work contributes to evidence-based plastic and reconstructive surgery — helping clinicians interpret outcomes, refine technique, and counsel patients with clearer data.

Author

Dr. Orr Shauly

Plastic and reconstructive surgery resident at Emory University (UCLA BS, USC MD) with an h-index of 15 and peer-reviewed work spanning aesthetic surgery, reconstruction, medical devices, and AI in medicine.

Abstract

Subfascial breast augmentation is a technique originally developed to reduce the risks of capsular contracture while decreasing the postoperative pain associated with subpectoral augmentation. It was pioneered in Brazil by Dr. Graf and others, and recently this technique has gained interest in the aesthetic world. A systematic analysis of subfascial breast augmentation was conducted to assess the combined reported rates of capsular contracture, animation deformity, and complications. The PubMed, Embase, and Web of Science databases were searched for studies on the subfascial plane for breast augmentation. A total of 3743 patients across 22 studies were analyzed, with 38 cases of capsular contracture, representing a rate of 1.01%. Several infections were reported, representing a rate of 0.1%. Animation deformity was not reported, though rippling, malrotation, axillary banding, sensory deficit, and asymmetry were occasionally observed. Subfascial breast augmentation appears to have a low complication rate and an extremely low rate of capsular contracture at approximately 1%. This technique may provide the benefits of low rates of capsular contracture while avoiding the discomfort and future animation deformity associated with subpectoral augmentation.