Self-expanding prostheses complicating augmentation mammoplasties

Signorini, M.; Grisotti, A.; Ponzielli, G.; Pajardi, G.; Gilardino, P.

doi:10.1007/bf00454482

Cited by 14 publications

(3 citation statements)

References 35 publications

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“…In January 1992, the Italian Minister of Health took a different approach. He banned the use of single-lumen silicone gel devices, but allowed the use of double-lumen devices with silicone gel in the central core and saline in the outer lumen (2). In Italy, double-lumen devices, which had become old-fashioned, suddenly gained renewed popularity.…”

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“…Signorini et al (2) postulated that there were three potential causes of the autoinflation that could be acting simultaneously. First, they suggested that all of the outer lumens of the implants had initially been filled with a hypertonic solution, creating an osmotic gradient.…”

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confidence: 99%

“…The salt used in the texturing process of the outer surface of textured implants could contribute to the concentration of sodium chloride in the implant (2).…”

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Autoinflation of Saline-Filled Inflatable Breast Implants

Peters

2006

Canadian Journal of Plastic Surgery

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Spontaneous autoinflation of saline-filled breast implants is a rare phenomenon; only 20 cases have been reported in the world literature. Over the past seven years, three patients have presented with significant unilateral autoinflation of their smooth, single-lumen, round, saline-filled implants. This developed at various times: progressively over 23 years with a Simaplast implant; between the ninth and 10th year after augmentation with a leaflet valve implant; and slowly over the first four years with a leaflet valve implant. The etiology of the autoinflation was shown to be different for the two types of implants. The Simaplast implant had likely been injected with a hypertonic filling solution -one that was twice as concentrated as 'normal saline'. This would have created an osmotic gradient, which would have facilitated autoexpansion by diffusion. The implant solution remained clear and transparent. In addition, there were no detectable levels of glucose, uric acid or albumin in the fluid. By contrast, auto-inflation of the leaflet valve implants likely resulted from mechanical alterations of the valve mechanism. This type of implant is known to have a high deflation rate, with frequent partial deflations. It is interesting that one of the patients with the leaflet valve implants presented with an autoexpansion on one side and a partial deflation on the other side. Both implants were from the same lot number. The same mechanism that caused partial deflations may have also allowed fluid from the implant pocket to pass through the valve into the lumen of these implants. This could allow glucose, protein and cellular elements to enter into the lumen (these would not pass through an intact elastomeric shell) which would create an osmotic gradient, allowing water to enter the elastomeric shell by diffusion. The fluid in these leaflet valve implants was brownish yellow, very viscous and turbid. It contained elevated levels of glucose and uric acid which would not have passed through the elastomeric shell. Over the past 10 years, four different theories have been proposed in an attempt to explain the etiology of autoinflation. However, the findings of the present study indicate that there are only two mechanisms -a hypertonic filling solution and alterations of the valve mechanism.Key Words: Autoinflation; Saline-filled breast implants L'autogonflement des implants mammaires remplis de sérum physiologique L'autogonflement spontané des implants mammaires remplis de sérum physiologique est un phénomène rare, puisque 20 cas seulement ont été déclarés dans les publications mondiales. Depuis sept ans, trois patients ont présenté un autogonflement unilatéral important de leurs implants remplis de sérum physiologique ronds, souples et monolumières. Cette occurrence se déclare à divers moments : progressivement, sur une période de 23 ans, avec des implants Simaplast; entre la neuvième et la dixième année suivant l'augmentation mammaire avec des implants avec valve; et lentement, au cours des quatre premières années, avec...

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