The management of the capsular contracture after breast surgery with implants is challenging. For years leukotriene antagonists have been used off-label, but they are not without adverse effects. Since boswellic acids inhibit the synthesis of leukotrienes, we evaluated their efficacy in treating the capsular contracture. From March 2020 to June 2022, twenty-eight patients with capsular contracture higher than Baker I were treated with Capsulase®. The patients were assessed clinically at 1, 2, 3 and 6 months and the response was defined as complete, partial or nil. At the same times, they were also asked to answer a questionnaire and the outcomes were rated on a four-point Likert scale. Forty-two breasts presented capsular contracture. A positive response (complete or partial) was obtained in 71% of treated breasts (p < 0.05). None of the patients worsened. The improvement was maintained until the 6th month in 77,7% of the cases who responded positively. Subjectively, the consistency improved by 50% and the pain by 91.1% at 6 months. Our study shows that Capsulase® improves capsular contracture. Mild capsular contracture appeared to better improve rather than more severe ones. Capsulase® is well tolerated with minimal side effects.

Antonio Zaffiro has completed his residency program at the age of 32 years from the University of Naples Federico II, Italy. He is clinical director and attending plastic surgeon at the San Carlo Regional Hospital in Potenza. He is instructor at the postgraduate master’s program in Aesthetic Medicine at the University of Naples Federico II. Also, he is instructor in Aesthetic Medicine within the Plastic Surgery Residency Program at the University of Naples Federico II.