Augmentation Mammaplasty Using Implants: A Review

Abstract

One of the techniques for augmentation mammaplasty is the procedure using implants. Even though this technique has been used for many years, there are still several controversial issues to be discussed and overcome for patient safety. In this review article, capsular contracture, leak or rupture of the implants, possible systemic disease, relation with breast cancer, and recent problems with Poly Implant Prothese implants are described and discussed.

The Effect of Montelukast and Antiadhesion Barrier Solution on the Capsule Formation after Insertion of Silicone Implants in a White Rat Model

“…This is a normal ‘defense' mechanism of the body against foreign body materials. Capsular contracture is the phenomenon which occurs when the capsule is abnormally thickened and becomes firm and hardened [8]. In some cases, it induces fibrotic changes in the adjacent soft tissue and also causes pain and deformity of the external appearance of the breast.…”

An Innovative Procedure for the Treatment of Primary and Recurrent Capsular Contracture (CC) Following Breast Augmentation

“…1 A normal tissue response consisting of inflammatory infiltration and deposition of collagen fibers forming a collagenous capsule surrounding the foreign material is inevitable regardless of the implant type. 2 Capsular contracture (CC) remains, however, a major yet unpredictable local potential complication.…”

“…7 Foreign body reaction is not yet fully understood and the pathogenesis of CC is still unclear, but it is believed to be mostly multifactorial, influenced by patient age, type of implant (shape, surface, and material), silicone leakage, individual susceptibility and propensity for hypertrophic scarring, surgical technique, surgical incision site, and occurrence of postoperative complications such as bleeding and hematoma formation. 1,4,7,[11][12][13][14] Recent evidence suggests that subclinical infection and the presence of a bacterial biofilm on the surface of the implant could be a likely major contributor to CC. [15][16][17] Interestingly, a high bacterial colonization rate of 61% to 66.7% has been detected in association with grade III and IV contractures, suggesting that bacterial stimuli may accelerate the process of inflammation and fibrosis.…”

“…7 Although the role of textured-surface implants in reducing the rate of CC remains controversial, 4 attention must be drawn to the relatively new phenomena of double capsule and late seroma only seen with Biocell textured-surface implants (Allergan, Inc, Irvine, California). 1,22 Reported recommendations to prevent CC include precise hemostasis, sterile surgical technique, placement of the implant beneath the pectoralis major muscle, use of saline implants, use of nipple shields, use of antibiotic-impregnated mesh, and breast massage. 1,14,17 At present, none of the available preventive measures are effective.…”

“…1,22 Reported recommendations to prevent CC include precise hemostasis, sterile surgical technique, placement of the implant beneath the pectoralis major muscle, use of saline implants, use of nipple shields, use of antibiotic-impregnated mesh, and breast massage. 1,14,17 At present, none of the available preventive measures are effective. 1,12 As for treatment, many modalities have been advocated.…”