Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Plastic and Reconstructive Surgery


Elyse Watkins, DHSc, PA-C, DFAAPA




The purpose of this article is to review the off-label utilization of leukotriene antagonists in breast augmentation patients and the effect they may have on the prophylaxis or treatment of capsular contracture.


A literature search was conducted on PubMed, Aesthetic Surgery Journal (ASJ), and Plastic and Reconstructive Surgery Journal (PRS) with search terms montelukast, capsular contracture, leukotriene antagonist, and breast augmentation. Twelve pertinent articles were retrieved, and they serve as the basis for this clinical review.


There is evidence-based research that supports the correlation of the use of leukotriene antagonists for prophylaxis and treatment of capsular contracture in breast augmentation patients.


Leukotriene antagonists have been shown to be effective in improving existing contractures and minimizing the risk of developing a contracture post-operatively. Currently, the only definitive treatment for the most common complication of breast augmentation with the use of an implant is surgery, making the use of leukotriene antagonists a monumental, non-invasive treatment option. Not only are they an option for mitigating the risk of developing a capsular contracture, but leukotriene antagonists have also been shown to be effective in improving existing contractures. While some leukotriene antagonists have serious side effects, montelukast is a safe and well-tolerated medication that may be a great option for peri-operative treatment in patients undergoing breast augmentation with implant placement. Further research is needed to solidify the quantitative risk reduction in prophylactic leukotriene antagonist treatment in breast augmentation patients with implants.


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