Effect of Povidone Iodine on Silicone Gel Breast Implants In Vitro: Implications for Clinical Practice

Abstract

Irrigation of breast implants and breast implant pockets with various solutions, including povidone iodine, has been a common practice among plastic surgeons for many years. Recent reports of potential weakening of silicone tubing have led the Food and Drug Administration to pronounce any contact of povidone iodine with breast implants a contraindication. An in vitro experimental study was undertaken to assess the effect of povidone iodine on the physical properties of silicone breast implant shells. Identical specimens were obtained from the shells of silicone breast implants according to published standards. The specimens were randomly assigned to eight groups of five and incubated in various solutions of decreasing concentration of povidone iodine (10% to 0.01%), and a control group (0.9% saline) was used. The containers were stored in a warming cabinet at 37 degrees C for 4 weeks. Testing of the specimens for tensile strength following 4 weeks of incubation showed no significant difference among any of the groups, including the control group. In addition, no correlation was shown between the concentration of the solution used and the tensile strength of the specimens.

Enhancing Patient Outcomes in Aesthetic and Reconstructive Breast Surgery Using Triple Antibiotic Breast Irrigation: Six-Year Prospective Clinical Study

“…We do not disagree with many who find it illogical that the Food and Drug Administration has not reconsidered its strange decision to restrict povidone-iodine usage when there have now been multiple studies that have not found any detrimental implant effect of extraluminal povidone-iodine. 15,16,27,28 Despite the bureaucracy of this process, keep in mind that the off-label use of povidone-iodine-containing breast irrigation is still permissible at the discretion of the operating surgeon. In this situation, the surgeon can disclose the intention to use povidone-iodine to the patient with appropriate background information, and we have found patients to be not only accepting but grateful that their physician is acting in their best interest.…”

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

“…Although early studies postulated a theoretical risk of deflation with betadine, 8,9 more recent research (as well as our own experience) indicates that this is not the case. 10 With studies confirming the protective effect against capsular contracture in vitro, 11 this factor may be a significant contributor to the low capsular contracture rate seen in this study.…”

Is Salvage of Recently Infected Breast Implant After Breast Augmentation or Reconstruction Possible? An Experimental Study

“…The minor disruptions induced by a smooth brush on the prosthesis were insignificant compared to the tests performed at the factory (Mentor Ò Corporation Santa Barbara, Calif.). Moreover, the decision to use Betadine was also affirmed by the experimental study of Zambacos and Nguyen [26], who studied the effects of different concentrations of povidone-iodine (0.01-10%) on silicone shells and found no structural modification [26]. In other words, a brief contact of the implant with Betadine, during the decontamination procedure, and followed by copious saline solution irrigation, has no effect on the long-term integrity of the shell of the implant.…”