Is the shear wave sonographic elastography correlated with pain after breast augmentation with silicone implants an indication of inflammatory activity? A preliminary report.

Abstract

IntroductionFormation of a capsule is a natural inflammatory response to a foreign body such as a breast implant. Breast capsular contracture is the most severe complication of implant surgery.AimTo evaluate breast tissues and the periprosthetic reaction with sonoelastography.Material and methodsNineteen patients aged 20-41 underwent breast augmentation with silicone-filled implants. Their 38 breasts were evaluated before surgery, and 7 and 14 days after surgery. Whole breast stiffness was measured by applanation tonometry. Patients underwent shear wave elastography and Young's moduli of breast tissues and the periprosthetic capsule were estimated. During surgery patients underwent standard anaesthesia and were released home 2 days later after removal of drainage. Each day, patients completed the pain visual analogue scale questionnaire separately for left and right breasts.ResultsApplanation tonometry did not correlate with any parameter. In shear wave elastography we observed statistically significant changes in elasticity of all breast tissues with the highest values on day 7 after surgery and decreasing on day 14. The correlations between pain and capsule elasticity in lower quadrants measured were significant between days 4 and 10, whereas correlations of pain with applanation tonometry were insignificant. Glandular tissue elasticity in lower quadrants did not correlate with pain, whereas in upper quadrants there was a significant correlation on days 6-10. Fatty tissue, muscle and thoracic fascia elasticity did not correlate with breast pain. Breast implant volume correlated with pain only shortly after surgery, but did not correlate with any sonoelastographic parameters.ConclusionsBreast pain correlates strongly with periprosthetic stiffness in elastography 4 to 10 days after breast augmentation, suggesting the possible role of an inflammatory reaction.

Drainage Collection After Endoscopic-Assisted Transaxillary Dual-Plane Augmentation Mammaplasty Using Cold or Electrosurgical Separation of Interpectoral Space

“…32 The results of previous studies are in accordance with our findings. [33][34][35][36] Furthermore, the drainage time was mostly longer than 72 hours after surgery in our study, which was greater than the time reported in the literature (ie, 24-72 hours). 31,[34][35][36] Unfortunately, the use of postoperative drainage in breast augmentation is seldom specified in reports describing the electrosurgical method.…”

“…[33][34][35][36] Furthermore, the drainage time was mostly longer than 72 hours after surgery in our study, which was greater than the time reported in the literature (ie, 24-72 hours). 31,[34][35][36] Unfortunately, the use of postoperative drainage in breast augmentation is seldom specified in reports describing the electrosurgical method. [33][34][35][36] This may be because most augmentation mammaplasties are performed in the clinic, and no drainage tube is placed.…”

“…31,[34][35][36] Unfortunately, the use of postoperative drainage in breast augmentation is seldom specified in reports describing the electrosurgical method. [33][34][35][36] This may be because most augmentation mammaplasties are performed in the clinic, and no drainage tube is placed. However, our study showed that the total drainage volume could reach 392 mL and 710 mL after surgery using the cold and the electrosurgical methods, respectively.…”

Sonoelastography in the evaluation of capsule formation after breast augmentation – preliminary results from a follow-up study

“…The procedure was performed by a senior plastic surgeon between September 2010 and March 2011. The dual-plane surgical technique was used, as described previously [ 9 , 10 ].…”

“…The breast stiffness was also determined by applanation tonometry, and the value of the intramammary pressure was calculated from the formula P = F/A , where F is the force applied to the organ and A is the contact area of the disc, which weighed 213 g and had a diameter of 20.3 cm [ 9 , 10 ].…”