A Prospective Study of 708 Form-Stable Silicone Gel Breast Implants

Stevens, W. Grant; Hirsch, Elliot M.; Tenenbaum, M; Guerrero, María Eugenia

doi:10.1177/1090820x10381880

Cited by 25 publications

(6 citation statements)

References 14 publications

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“…Baker grade III/IV CC was seen in 1.2% of cases. Several factors may have contributed to the low rates of CC including the utilization of anatomic gel implants 37 and the use ADM 38–40 and mesh, 7,41 which are associated with decreased incidences of CC. Capsules around textured subcutaneous prostheses may also be thinner than those found with submuscular placement at short-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Implant-based Breast Reconstruction with Acellular Dermal Matrix/Mesh: A Systematic Review

Salibian

Frey

Choi

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:The availability of acellular dermal matrix (ADM) and synthetic mesh products has prompted plastic surgeons to revisit subcutaneous implant-based breast reconstruction. The literature is limited, however, with regards to evidence on patient selection, techniques, and outcomes.Methods:A systematic review of the Medline and Cochrane databases was performed for original studies reporting breast reconstruction with ADM or mesh, and subcutaneous implant placement. Studies were analyzed for level of evidence, inclusion/exclusion criteria for subcutaneous reconstruction, reconstruction characteristics, and outcomes.Results:Six studies (186 reconstructions) were identified for review. The majority of studies (66.7%) were level IV evidence case series. Eighty percent of studies had contraindications for subcutaneous reconstruction, most commonly preoperative radiation, high body mass index, and active smoking. Forty percent of studies commenting on patient selection assessed mastectomy flap perfusion for subcutaneous reconstruction. Forty-five percent of reconstructions were direct-to-implant, 33.3% 2-stage, and 21.5% single-stage adjustable implant, with ADM utilized in 60.2% of reconstructions versus mesh. Pooled complication rates included: major infection 1.2%, seroma 2.9%, hematoma 2.3%, full nipple-areola complex necrosis 1.1%, partial nipple-areola complex necrosis 4.5%, major flap necrosis 1.8%, wound healing complication 2.3%, explantation 4.1%, and grade III/IV capsular contracture 1.2%.Conclusions:Pooled short-term complication rates in subcutaneous alloplastic breast reconstruction with ADM or mesh are low in preliminary studies with selective patient populations, though techniques and outcomes are variable across studies. Larger comparative studies and better-defined selection criteria and outcomes reporting are needed to develop appropriate indications for performing subcutaneous implant-based reconstruction.

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Section: Discussionmentioning

confidence: 99%

Subcutaneous Implant-based Breast Reconstruction with Acellular Dermal Matrix/Mesh: A Systematic Review

Salibian

Frey

Choi

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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“…Many other authors have reported similar findings. [16][17][18][19][20] Fewer investigators have studied the rates of CC after transaxillary augmentation. Huang et al 21 reported a perpatient CC rate of 1.9%, with 0.6% in saline augmentation and 2.9% in silicone gel augmentation.…”

Section: Discussionmentioning

confidence: 99%

Capsular Contracture Rate in a Low-Risk Population After Primary Augmentation Mammaplasty

Blount¹,

Martin²,

Lineberry³

et al. 2013

Aesthetic Surgery Journal

116

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Background: The safety of augmentation mammaplasty has increased dramatically in the past 20 years. Capsular contracture (CC) is the most commonly reported complication of augmentation mammaplasty. Objectives: The authors report the incidence of CC in a low-risk patient population after primary augmentation. Methods: The authors retrospectively reviewed the charts of 856 consecutive patients who underwent primary augmentation mammaplasty between 1999 and 2009. This series did not include patients who underwent breast augmentation-mastopexy, secondary augmentation, revision, and/or reconstruction. Data points included demographics, functional and aesthetic outcomes, complications, and revision rate/type. Results: The overall incidence of CC in 856 patients was 2.8%. Average follow-up time was 14.9 months. Antibiotic irrigation decreased CC rates from 3.9% to 0.4% (P = .004). Tobacco users had higher rates of contracture than nonsmokers (5.5% vs 1.9%; P = .036). Saline implants had a higher CC rate than silicone gel (4.3% vs 1.3%; P = .032). Using multivariate logistic regression, CC was 7.89 times more likely in saline implants than in silicone gel (P = .027, 95% confidence interval, 1.26-49.00). Conclusions: Based on our findings, it is apparent that the early CC rate in primary augmentation can be less than 1%. To avoid CC, we advocate an inframmamary approach, submuscular implant placement, and antibiotic irrigation of the breast pocket. Level of Evidence: 3

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“…Rupture of saline implants is readily apparent by clinical examination and requires no imaging. 3,4,[9][10][11] Many injection ports are not MRI compatible, and studies have raised concerns about dislodgement; in addition, they can produce significant artifact.…”

Section: Types Of Implantsmentioning

confidence: 99%

Magnetic Resonance Imaging of Breast Implants

Shah

Tanna

Margolies³

2014

Topics in Magnetic Resonance Imaging

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Silicone breast implants have significantly evolved since their introduction half a century ago, yet implant rupture remains a common and expected complication, especially in patients with earlier-generation implants. Magnetic resonance imaging is the primary modality for assessing the integrity of silicone implants and has excellent sensitivity and specificity, and the Food and Drug Administration currently recommends periodic magnetic resonance imaging screening for silent silicone breast implant rupture. Familiarity with the types of silicone implants and potential complications is essential for the radiologist. Signs of intracapsular rupture include the noose, droplet, subcapsular line, and linguine signs. Signs of extracapsular rupture include herniation of silicone with a capsular defect and extruded silicone material. Specific sequences including water and silicone suppression are essential for distinguishing rupture from other pathologies and artifacts. Magnetic resonance imaging provides valuable information about the integrity of silicone implants and associated complications.

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A Prospective Study of 708 Form-Stable Silicone Gel Breast Implants

Cited by 25 publications

References 14 publications

Subcutaneous Implant-based Breast Reconstruction with Acellular Dermal Matrix/Mesh: A Systematic Review

Subcutaneous Implant-based Breast Reconstruction with Acellular Dermal Matrix/Mesh: A Systematic Review

Capsular Contracture Rate in a Low-Risk Population After Primary Augmentation Mammaplasty

Magnetic Resonance Imaging of Breast Implants

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