Loss of Silicone Implants After Subcutaneous Mastectomy and Reconstruction

Schlenker, James D.; Bueno, Reuben A.; Ricketson, Greer; Lynch, John B.

doi:10.1097/00006534-197812000-00004

Cited by 103 publications

(48 citation statements)

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“…The history of implant‐based breast reconstruction started in 1962, when the first silicone breast implant became available . The immediate implantation of such prosthesis after subcutaneous mastectomy improved the aesthetic outcomes offering the possibility to reconstruct the breast in a one‐stage surgery without the need to expand or add skin . On the other hand, the major problems relating to the subcutaneous breast implant positioning were the high rates of capsular contracture, implant malposition, and exposure …”

Section: Introductionmentioning

confidence: 99%

“…1 The immediate implantation of such prosthesis after subcutaneous mastectomy improved the aesthetic outcomes offering the possibility to reconstruct the breast in a one-stage surgery without the need to expand or add skin. 2 On the other hand, the major problems relating to the subcutaneous breast implant positioning were the high rates of capsular contracture, implant malposition, and exposure. 2,3 Since Radovan introduced tissue expander, 4 the immediate subcutaneous breast reconstruction technique lost its popularity, giving way to the submuscular breast implant placement after the expansion of the pectoralis major.…”

Section: Introductionmentioning

confidence: 99%

“…2 On the other hand, the major problems relating to the subcutaneous breast implant positioning were the high rates of capsular contracture, implant malposition, and exposure. 2,3 Since Radovan introduced tissue expander, 4 the immediate subcutaneous breast reconstruction technique lost its popularity, giving way to the submuscular breast implant placement after the expansion of the pectoralis major. Nevertheless, such submuscular implantation, in addition to extend the time of reconstruction in two surgeries, limits the proper positioning and projection of the prosthesis resulting in a contrived breast.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effectiveness of the prepectoral breast reconstruction with Braxon dermal matrix: First multicenter European report on 100 cases

et al. 2017

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We report the outcomes of the European prospective study on prepectoral breast reconstruction using preshaped acellular dermal matrix for complete breast implant coverage. Seventy-nine patients were enrolled between April 2014 and August 2015 all over Europe using a single protocol for patient selection and surgical procedure, according to the Association of Breast Surgery and British Association of Plastic Reconstructive and Aesthetic Surgeons joint guidelines for the use of acellular dermal matrix in breast surgery. The preshaped matrix completely wraps the breast implant, which is placed above the pectoralis major, without detaching the muscle. A total of 100 prepectoral breast reconstructions with complete implant coverage were performed. This series, with mean follow-up of 17.9 months, had two cases of implant loss (2.0%) including one necrosis of the nipple and one wound breakdown (1.0% respectively). No implant rotations were observed. Good cosmetic outcomes were obtained with natural movement of the breasts and softness to the touch; none of the patients reported experiencing pain or reduction in the movements of the pectoralis major muscle postoperatively. The use of preshaped acellular dermal matrix for a complete breast implant coverage in selected patients is safe and gives satisfactory results, both from the aesthetic view point and the low postoperative complication rates. Further studies reporting long-term outcomes are planned.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effectiveness of the prepectoral breast reconstruction with Braxon dermal matrix: First multicenter European report on 100 cases

et al. 2017

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“…Brand14 has confirmed this fact in an animal model, and clinical reports of infection rates with smooth-surface and polyurethanecovered implants in both aesthetic and reconstructive breast surgery fail to show an increased risk with the polyurethane-covered implant.3-7~9.10~15- 19 However, when infection does occur following the placement of a polyurethane-covered prosthesis, it is imperative that the surgeon understand the nuances of treatment related to the biophysical characteristics of this implant.…”

Section: Infectionmentioning

confidence: 94%

Diagnosis and Treatment of Complications Occurring With Polyurethane-Covered Breast Implants

Hester¹

1990

Seminars in Plastic Surgery

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Over the past 5 years the use of polyurethane-covered prostheses in aesthetic and reconstructive breast surgery has increased dramatically as plastic surgeons have become aware of at least three distinct advantages: (1) low incidence of capsular contracture, which occurs with their primary (2) provision of a predictably successful method of treatment of capsular contracture resulting from the use of smooth-surface silicone implants9-13; position^.^.^^ Although the incidence of major complications occurring with the use of polyurethane-covered prostheses is low, surgeons using them must be aware of certain variations of diagnosis and treatment. Other than rash and surface wrinkling, the complications that occur with polyurethane-covered implants are similar to those seen with standard silicone prostheses. However, there are some unique complication features that require experience to recognize and treat appropriately. The following complications are discussed: (1) infection, (2) rash, (3) recurrent capsular contracture, (4) hematoma, (5) seroma, (6) implant malposition, (7) implant rupture, (8) implant wrinkling, and (9) palpation of implant edge. INFECTIONThe perception held by some surgeons that the rate of infection is greater with the use of polyurethane-covered implants than with the smooth-surface variety is unfounded. Brand14 has confirmed this fact in an animal model, and clinical reports of infection rates with smooth-surface and polyurethanecovered implants in both aesthetic and reconstructive breast surgery fail to show an increased risk with the polyurethane-covered implant.3-7~9.10~15-19 However, when infection does occur following the placement of a polyureDownloaded by: National University of Singapore. Copyrighted material.

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“…In light of these innovations and advancements, prosthetic breast reconstruction in the prepectoral space is now possible. The concept is not novel and was performed in the 1970s but abandoned because of the high complication rates that included skin necrosis rates of 13.5%, device extrusion in 6.7%, capsular contracture in 56%, and explantation in 28% within the first year . This led to partial and total muscle coverage techniques placing devices under the pectoralis major muscle.…”

Section: Prepectoral Breast Reconstructionmentioning

confidence: 99%

Innovations and advancements with prosthetic breast reconstruction

Nahabedian

2018

Breast J

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Prosthetic breast reconstruction has evolved over the years to provide results that now mimic that of a natural breast. This is due to a variety of innovations and advancements related to mastectomy techniques, acellular dermal matrices, autologous fat grafting, and improved breast implants. The evolution of prosthetic breast reconstruction has gone full-circle and included prepectoral placement in the 1970s and 80s, partial or total subpectoral placement from 1985 to 2015, and now gradually trending back to prepectoral. There are several techniques and strategies that now allow for patients to achieve results that are superior to any time over the past 50 years. This manuscript will review the salient aspects of prosthetic breast reconstruction and how its evolution has progressed over the years.

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Loss of Silicone Implants After Subcutaneous Mastectomy and Reconstruction

Cited by 103 publications

References 0 publications

Evaluation of the effectiveness of the prepectoral breast reconstruction with Braxon dermal matrix: First multicenter European report on 100 cases

Evaluation of the effectiveness of the prepectoral breast reconstruction with Braxon dermal matrix: First multicenter European report on 100 cases

Diagnosis and Treatment of Complications Occurring With Polyurethane-Covered Breast Implants

Innovations and advancements with prosthetic breast reconstruction

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