scholarly journals Tumor Remnant After Silicone Implant en Block Capsulectomy: The Magnetic Resonance Role

2021 ◽  
Author(s):  
Eduardo Faria Castro Fleury
Keyword(s):  
Magnetic Resonance ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Residual Tumor ◽  
Large Cell ◽  
Scar Tissue ◽  
Silicone Implants ◽  
Short Report ◽  
Surgical Time ◽  
Tumor Remnant

Abstract Recently, there has been an increase in surgeries to treat silicone implants complications. These procedures are generally related to diseased fibrous capsules, whose most common clinical manifestation is capsular contracture. Other frequently found presentations are intracapsular collection and local inflammatory signs. The causes of these complications are not well established. Some reports associate them with the implant texture, gel bleeding, silicone-induced granuloma, and infectious processes. Although rare, there is an association with malignant neoplasia in the literature, where Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is the most severe complication. Patients often do not perform a Magnetic Resonance (MRI) scan for the explant surgical programming.The accuracy of MRI to assess fibrous capsule tumor remnants depends on the surgical time. The ideal time for the evaluation is up to 72 hours after the surgical time when the repair tissue starts to appear. Up to 2-3 weeks after surgery, MRI can provide information regarding the presence of a residual tumor. After this period, the presence of scar tissue impairs the analysis. This short report discusses the role of MRI in the evaluation of residual fibrous capsules in the postoperative period.

scholarly journals The A, B and C’s of Silicone Breast Implants: Anaplastic Large Cell Lymphoma, Biofilm and Capsular Contracture

Materials ◽  
2018 ◽  
Vol 11 (12) ◽  
pp. 2393 ◽  
Author(s):  
Maria Mempin ◽  
Honghua Hu ◽  
Durdana Chowdhury ◽  
Anand Deva ◽  
Karen Vickery
Keyword(s):  
Anaplastic Large Cell Lymphoma ◽  
Biofilm Formation ◽  
Cell Lymphoma ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Surface Characteristics ◽  
Large Cell ◽  
Breast Implantation ◽  
Large Cell Lymphoma

Breast implantation either for cosmetic or reconstructive e purposes is one of the most common procedures performed in plastic surgery. Biofilm infection is hypothesised to be involved in the development of both capsular contracture and anaplastic large cell lymphoma (ALCL). Capsular contracture is one of the principal reasons for breast revision surgery and is characterised by the tightening and hardening of the capsule surrounding the implant, and ALCL is an indolent lymphoma found only in women with textured implants. We describe the types of breast implants available with regard to their surface characteristics of surface area and roughness and how this might contribute to capsular contracture and/or biofilm formation. The pathogenesis of capsular contracture is thought to be due to biofilm formation on the implant, which results in on-going inflammation. We describe the current research into breast implant associated ALCL and how implant properties may affect its pathogenesis, with ALCL only occurring in women with textured implants.

scholarly journals Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 28-34
Author(s):  
Kumkum Vadehra ◽  
Jennifer Cai ◽  
Rashmi Rekha Bhuyan ◽  
Ping Ji ◽  
Rose Venegas ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Anaplastic Large Cell Lymphoma ◽  
Cell Lymphoma ◽  
Breast Implant ◽  
Fluid Collection ◽  
Breast Implants ◽  
Large Cell ◽  
Silicone Implants ◽  
Axillary Lymph ◽  
Large Cell Lymphoma

Breast implant-associated anaplastic large cell lymphoma (ALCL) is a recently recognized type of T-cell lymphoma that can develop following breast implants, with morphologic and immunophenotypic features indistinguishable from those of ALK-negative ALCL. Here we report a case of a 58-year-old woman with a history of subglandular silicone implants placed for bilateral breast augmentation 25 years ago, who presented with bilateral breast pain and was found to have bilateral Baker Grade III capsular contracture, and heterogenous fluid collection centered near the left third costochondral articulation, a suspicious left chest wall lesion, and left axillary lymphadenopathy on imaging. A left axillary lymph node core biopsy and an aspiration of the fluid were performed, and no malignant cells were identified. The patient underwent bilateral removal of breast implants and total capsulectomies. Microscopic examination of the capsule surrounding the left breast implant revealed large pleomorphic tumor cells in a fibrinous exudate. By immunohistochemistry, the tumor cells were found to be positive for CD3 (subset), CD4, CD7, CD30 (strong and uniform), and CD43, and negative for CD2, CD5, CD8, and ALK1, supporting the diagnosis of breast implant-associated ALCL. No lymphoma cells were identified in the right breast capsule, confirmed by CD30 stain. Breast implant-associated ALCL is a very rare disease that can develop many years after breast implant placement. Proper evaluation with breast imaging and pathologic workup is essential to confirm the diagnosis in suspected cases. Our case highlights that adequate sampling is important in the investigation of patients with suspected breast implant-associated ALCL.

Prevention of Capsular Contracture with Montelukast After Insertion of Silicone Implants in Rabbits

2016 ◽  
Vol 13 (10) ◽  
pp. 7623-7627
Author(s):  
Zhenyu Jin ◽  
Ki Yong Hong ◽  
Kyung Won Minn ◽  
Hak Chang ◽  
Ung Sik Jin
Keyword(s):  
Breast Implant ◽  
Capsular Contracture ◽  
White Female ◽  
Silicone Implants ◽  
Control Group ◽  
Tissue Samples ◽  
Significant Difference ◽  
Group A ◽  
The Right ◽  
Experimental Group

Capsular contracture is the most common complication after insertion of silicone implants during breast implant surgery. The discovery that myofibroblasts play an important role in the formation of hypertrophic scars led to the development of pharmacological drugs such as zafirlukast, which prevents capsular contracture by resisting the above mechanism. As a result, the author sought to investigate the effect of the anti-leukotriene montelukast on capsular contracture. Ten white female New Zealand rabbits, each weighing approximately 3 kg, were used as subjects. Through bilateral incision of the midback area, the prostheses were inserted on the subpanniculus carnosus plane. Once the silicone prostheses had been inserted, the right implant was injected with 10 mL of montelukast (10 µg/mL), and the left implant was injected with 10 mL of normal saline. Eight weeks after the procedure, the capsular pressure was measured via tonometry using a circular glass piece weighing 42.7 g. The tissue samples were then extracted, and their thicknesses were measured using hematoxylin-eosin stain and Masson trichrome stain. The average pressure was 4.23±0.99 mmHg in the control group and 3.71±0.51 mmHg in the experimental group, a statistically significant difference (p = 0.02). The average capsular thickness was 947.938±300 µm in the control group and 709.672±274 µm in the experimental group, a statistically significant difference (p = 0.028). The author confirmed that montelukast injections during silicone prosthesis insertion decreased the formation of capsular contracture.

scholarly journals Experimental model of capsular contracture in silicone implants

2003 ◽  
Vol 18 (spe) ◽  
pp. 22-28 ◽  
Author(s):  
Érika Malheiros Bastos ◽  
Miguel Sabino Neto ◽  
Lydia Masako Ferreira ◽  
Élvio Bueno Garcia ◽  
Richard Eloin Liebano ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Experimental Model ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Silicone Implants ◽  
Frequent Complication

The breast implant procedure is one of the most performed into Plastic Surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. We describe here one experimental model of capsule contracture in rats.

Breast Augmentation

2019 ◽  
Author(s):  
Eric J. Culbertson ◽  
William P. Adams Jr
Keyword(s):  
Breast Augmentation ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Postoperative Recovery ◽  
Silicone Implants ◽  
Aesthetic Result ◽  
Incision Location ◽  
Implant Selection

Breast augmentation is a complicated process that goes far beyond placing an implant in a pocket. The implants and techniques of breast augmentation have undergone significant evolution over the past 50 years, and this is now one of the most commonly performed cosmetic procedures worldwide. Advancements in shell barrier technology and silicone form stability have improved implant functional characteristics and mechanical properties. Tissue-based planning uses measurable patient characteristics to match an implant to the patient’s tissue for greater control of the aesthetic result while minimizing complications. The realization of three-dimensional modeling systems allows a more sophisticated approach to implant selection and establishment of patient expectations. Specific surgical techniques, including pocket plane and incision location, ensure ideal implant placement. Optimal patient outcomes are achieved by integrating patient education, implant selection with tissue-based planning, refined surgical technique, and detailed postoperative recovery.  This review contains 12 figures, 6 tables, 1 video, and 74 references. Key Words: breast augmentation, breast implants, breast implant-associated anaplastic large cell lymphoma, dual plane, capsular contracture, saline implants, silicone implants, tissue-based planning, three-dimensional imaging 

scholarly journals Five Year Safety and Satisfaction With the Lightweight Breast Implant

2021 ◽  
Author(s):  
Orel Govrin-Yehudain ◽  
Noam Calderon ◽  
Jacky Govrin-Yehudain
Keyword(s):  
Breast Implant ◽  
Capsular Contracture ◽  
Surgical Techniques ◽  
Silicone Implants ◽  
Form And Function ◽  
Kaplan Meier ◽  
And Performance ◽  
The Aesthetic ◽  
And Function ◽  
Surgeon Satisfaction

Abstract Background The B-Lite® lightweight breast implant (LWBI), weighs ~ 30% less than traditional silicone implants, while maintaining an equivalent size, form and function. The LWBI thus places less stress on breast tissues, preserves tissue stability and integrity over time, reducing weight-related complications and reoperation rates. Objectives To assess the long-term (over 5 year) safety and performance of the LWBI in primary and revision augmentation procedures. Methods Retrospective single-center, single surgeon analysis of prospectively collected data, was performed on 827 consecutive primary and revision augmentation patients operated between December 2013 and January 2019. 1653 implants (250-835 cc, mostly round, textured, extra high-profile) were implanted using standard surgical techniques. Direct physician-to-patient follow-up ranged from 6 to 67 months. Chart data on reoperations and overall complications as well as patient and surgeon satisfaction, were analyzed. Results The 5 year Per Patient Kaplan–Meier reoperation free rate was very high (97.1%). Only 2 out of 5 total cases of capsular contracture grade III required reoperation (KM rate 0.2%, CI- 0.1-1.0). No cases of rupture or BIA-ALCL were recorded. 94.9% of patients rated the aesthetic outcome, and 95.5% of patients rated the natural look and feel of their breasts, at 4-5 (Satisfied-Very Satisfied). Similarly, the surgeon rated 4-5 on 95.4% of the patients’ aesthetic outcomes. Conclusions The extremely favorable safety profile, high patient and surgeon satisfaction, and inherent benefits of reduced weight, in the largest known study of B-Lite® implant surgeries, should make the LWBI a strongly considered strategic alternative to traditional implants.

scholarly journals Breast implant rupture 37 years after breast augmentation

2021 ◽  
pp. 69-69
Author(s):  
Marko Jovic ◽  
Ivan Radosavljevic ◽  
Jovan Mihaljevic ◽  
Jelena Jeremic ◽  
Milan Jovanovic
Keyword(s):  
Breast Augmentation ◽  
First Generation ◽  
Histopathological Examination ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Surrounding Tissue ◽  
Silicone Implants ◽  
Complication Rates ◽  
Macroscopic Appearance ◽  
Implant Rupture

Introduction Silicone implants have been used ever since the second half of the 20th century. Over that period several generations of implants have been developed that differed in thickness of the shell and viscosity of the silicone gel. Development of these generations of implants was accompanied with different complication rates. The first-generation implants had the lowest tendency to rupture, but were more prone to capsular contracture and calcification formation. Case outline An 81-year-old female patient had her silicone implants placed in 1983. After a chest injury in 2015. on the lateral aspect of the left breast a tumefaction becomes palpable and she complains of pain. She denies any subjective problems before the injury. After pertinent diagnostic procedures and clinical examination, silicone implant rupture was suspected. Surgical findings confirmed ruptures of both implants so that they were extracted, capsulectomy was performed and the surrounding tissue imbibed with silicone removed. Samples were sent for histopathological examination. Conclusion Implant rupture is one of late complications of breast augmentation. The incidence of ruptures has changed with development of newer generations of silicone implants. We believe that our patient had the first-generation silicone implants, knowing the time from their placement to the occurrence of symptoms and macroscopic appearance of the shell after extraction. The fact is that these implants have proved to be very durable, but regardless of the lack of symptoms, current guidelines recommend regular screening for rupture, while possible preventive extraction, particularly in case of so old implants should be considered.

scholarly journals Research Related to Capsular Contracture after Breast Augmentation for Cosmetic or Reconstructive Purposes

2019 ◽  
Vol 70 (5) ◽  
pp. 1619-1624
Author(s):  
Silviu Adrian Marinescu ◽  
Dan Mircea Enescu ◽  
Catalin Gheorghe Bejinariu ◽  
Carmen Giuglea
Keyword(s):  
Breast Augmentation ◽  
Cell Lymphoma ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Large Cell ◽  
Upward Trend ◽  
Silicone Breast Implants ◽  
Number Of Patients ◽  
Alloplastic Breast Reconstruction

The upward trend of patients opting for elective breast augmentation, as well as the large number of patients benefiting from alloplastic breast reconstruction, require further studies on the safety profile of these techniques. Without any doubt, the incidence of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) has drawn attention to the possible unknown complications characteristic of these procedures, creating the context of further studies devoted to this issue. The present research examines the capsular contracture rate on a group of 253 patients between 2015 and 2019, also proposing a scoring system based on the integration of the main diagnostic criteria related to the capsular contracture. The results of the literature review indicate that a lower incidence of capsular contracture could be achieved by using the newest techniques in the field involving the application of chemical substances on the surface of the latest generation of silicone breast implants.

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