Singular or accolate? Is one better than theother for capsular contracture?

Answers from doctors (7)


Barry J. Kaplan, D.O.

Published on Jun 09, 2016

I believe Accolate twice a day works and Singulair has been disappointing, though I admit my Singulair attempts have been small in number.

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Answered by Barry J. Kaplan, D.O.

I believe Accolate twice a day works and Singulair has been disappointing, though I admit my Singulair attempts have been small in number.

Published on Jul 11, 2012


ELLIOT B. DUBOYS, MD, FACS

Published on May 10, 2016

Personally, I do not use anything, and with silicone implants placed beneath the muscle, I have a low contracture rate. Thanks for the good question.

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Answered by ELLIOT B. DUBOYS, MD, FACS

Personally, I do not use anything, and with silicone implants placed beneath the muscle, I have a low contracture rate. Thanks for the good question.

Published on Jul 11, 2012


Jed Horowitz, M.D., F.A.C.S.

Published on Mar 14, 2016

Accolate may be more effective, but theoretically has more potential side effects.

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Answered by Jed Horowitz, M.D., F.A.C.S.

Accolate may be more effective, but theoretically has more potential side effects.

Published on Jul 11, 2012


Richard H. Tholen, M.D., F.A.C.S.

Published on Jun 16, 2015

Both Singulair and Accolate are leukotriene inhibitors that may be of benefit in minimizing an inflammatory cause of capsular contracture. Accolate does have some hepatic side effects, so its use should be restricted in patients with hepatic insufficiency, cirrhosis, hepatitis, etc. Singulair does not appear to have these hepatic concerns, so many practitioners who wish to provide their patients with leukotriene inhibitors will use Singulair. Singulair inhibits one pathway in the leukotriene inflammation process, whereas Accolate is thought to inhibit two discrete pathways, and may be more effective on this basis. Overall, only 50% of patients seem to respond to either therapy, but there is little lost and much to gain if the therapy is effective in reducing the severity of incidence of capsular contracture. Most plastic surgeons also add Vitamin E 400iU BID to Singulair or Accolate therapy, and will continue it for 3 months. Best wishes! Richard H. Tholen, M.D.

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Answered by Richard H. Tholen, M.D., F.A.C.S.

Both Singulair and Accolate are leukotriene inhibitors that may be of benefit in minimizing an inflammatory cause of capsular contracture. Accolate does have some hepatic side effects, so its use should be restricted in patients with hepatic insufficiency, cirrhosis, hepatitis, etc. Singulair does not appear to have these hepatic concerns, so many practitioners who wish to provide their patients with leukotriene inhibitors will use Singulair. Singulair inhibits one pathway in the leukotriene inflammation process, whereas Accolate is thought to inhibit two discrete pathways, and may be more effective on this basis. Overall, only 50% of patients seem to respond to either therapy, but there is little lost and much to gain if the therapy is effective in reducing the severity of incidence of capsular contracture. Most plastic surgeons also add Vitamin E 400iU BID to Singulair or Accolate therapy, and will continue it for 3 months. Best wishes! Richard H. Tholen, M.D.

Published on Jul 11, 2012


William Hedden, M.D.

Published on Jun 16, 2015

They both work but acolate has a bit more complications.

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Answered by William Hedden, M.D.

They both work but acolate has a bit more complications.

Published on Jul 11, 2012


Gerald Minniti, M.D., F.A.C.S

Published on Jun 16, 2015

Both of these drugs have been used for either treatment or prevention of capsular contracture. Unfortunately, there is no evidence at this time to suggest that either is effective or reliable at treatment of this problem. Because of this, and because Accolate has the potential of causing liver damage, the American Society of Plastic Surgeons made a statement to it's members in 2006 urging them not to use Accolate for capsular contracture. I am aware that some plastic surgeons are using these drugs and touting their benefits, even on line in forums, but the science doesn't support their claims.
There is more evidence that the use of Singulair in prevention of capsular contracture after surgical treatment for the problem may help decrease recurrence. I have found that by removing the entire capsule in one piece with the implant inside and replacing with a new implant has decreased recurrence rates to 5%, which is lower than the average rate of first time capsular contracture (15-20%). Therefore, I do not find the need for Singulair either.

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Answered by Gerald Minniti, M.D., F.A.C.S

Both of these drugs have been used for either treatment or prevention of capsular contracture. Unfortunately, there is no evidence at this time to suggest that either is effective or reliable at treatment of this problem. Because of this, and because Accolate has the potential of causing liver damage, the American Society of Plastic Surgeons made a statement to it's members in 2006 urging them not to use Accolate for capsular contracture. I am aware that some plastic surgeons are using these drugs and touting their benefits, even on line in forums, but the science doesn't support their claims.
There is more evidence that the use of Singulair in prevention of capsular contracture after surgical treatment for the problem may help decrease recurrence. I have found that by removing the entire capsule in one piece with the implant inside and replacing with a new implant has decreased recurrence rates to 5%, which is lower than the average rate of first time capsular contracture (15-20%). Therefore, I do not find the need for Singulair either.

Published on Jul 11, 2012


John J. O'Brien, Jr. M.D.

Published on Jun 16, 2015

Hello, and thank you for this question. Several studies have shown that both of these agents are affected although many plastic surgeons including myself do not like to use Accolate because several studies have shown higher complication rates and side effects. We are using Singulair with good results.I would recommend you discussed this with your treating plastic surgeon. Best of luck.

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Answered by John J. O'Brien, Jr. M.D.

Hello, and thank you for this question. Several studies have shown that both of these agents are affected although many plastic surgeons including myself do not like to use Accolate because several studies have shown higher complication rates and side effects. We are using Singulair with good results.I would recommend you discussed this with your treating plastic surgeon. Best of luck.

Published on Jul 11, 2012


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