Efficacy and Safety of Hydrodissection-based Capsulectomy for Improving Cervical Mobility and Appearance After Expanded Flap Transfer.

An expander capsule is a fibrous membrane that forms around an expander after tissue expansion. However, whether the capsule should be removed after the expander is removed remains controversial. The authors aimed to investigate the efficacy and safety of cervical capsulectomy for improving neck mobility and appearance after expanded flap transfer. We retrospectively analyzed patients with cervical scar contractures who underwent expanded flap transfer at our hospital between September 2018 and December 2023. Depending on whether capsulectomy was performed simultaneously with expander removal, the patients were divided into the capsule-retaining (n=50) and capsule-resecting (n=24) groups. The preoperative and postoperative cervicomental angles, neck extension range of motion, postoperative appearance satisfaction, cervical pulling sensation, cervical capsular contracture cords, and postoperative complication rates were compared between the 2 groups to evaluate the efficacy and safety of cervical capsulectomy. Complication rates were not significantly different between the groups (P>0.05). The postoperative improvements in the neck extension range of motion and cervicomental angle were significantly greater, and the appearance satisfaction score was higher in the capsule-resecting group than in the capsule-retaining group. In the capsule-retaining group, 18 (36.0%) patients experienced a significant pulling sensation during neck extension, and 10 (20.0%) patients had capsular contracture cords. The differences between the 2 groups were statistically significant (P<0.05). Cervical capsulectomy is safe and effective for improving neck mobility and appearance after expanded flap transfer.