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.

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 Does the Use of Intraoperative Breast Sizers Increase Complication Rates in Primary Breast Augmentation? A Retrospective Analysis of 416 Consecutive Cases in a Single Institution

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Lee Seng Khoo ◽  
Henrique N. Radwanski ◽  
Vasco Senna-Fernandes ◽  
Nsingi Nsosolo Antônio ◽  
Leonardo Luiz Fernandes Fellet ◽  
...  
Keyword(s):  
Complication Rate ◽  
Breast Augmentation ◽  
Capsular Contracture ◽  
Planning System ◽  
Silicone Implants ◽  
Complication Rates ◽  
Single Institution ◽  
Training Tool ◽  
Significant Difference ◽  
Novice Surgeon

Background. Is the use of intraoperative breast sizers beneficial for plastic surgeons or do they result in higher complication rates? Methods. This is a retrospective study of 416 consecutive cases of primary breast augmentation with silicone implants at the Plastic Surgery Service of Professor Ivo Pitanguy at the 38th Infirmary Santa Casa Misericórdia Hospital, Rio De Janeiro, from January 2011 to March 2014. 212 cases (51%) were carried out with use of intraoperative breast sizers with 204 cases (49%) without the use of implant sizers. This study compares the outcome of cases that employed the use of intraoperative implant sizers versus those that did not in terms of infection, hematoma/seroma formation, and capsular contracture. Results. Of 416 primary breast augmentation cases, there were 5 cases of infection (1.2%), 4 cases of seroma (1%), 3 cases of hematoma (0.7%), and 7 cases of capsular contracture (Baker’s Grade III/IV)(1.7%). Total complication rate limited to infection, seroma, hematoma, and capsular contracture was 1.15% (95% CI 0.96–1.93%). There was a significant difference in the scores for breast sizers (M = 4.3, SD = 1.4) and no breast sizers (M = 2.3, SD = 0.87) conditions, t(8) = 2.79, p=0.018. The use of implant sizers was correlated with a higher complication rate. Conclusion. Good results could be obtained without the use of breast sizers in primary breast augmentation with use of a biodimensional tissue based planning system while eliminating risks of infection and reducing intraoperative time. Notwithstanding, in a residency program breast sizers can be an excellent training tool to shorten the learning curve in the novice surgeon.

Transitioning From Conventional Textured to Nanotextured Breast Implants: Our Early Experience and Modifications for Optimal Breast Augmentation Outcomes

2020 ◽  
Author(s):  
Paolo Montemurro ◽  
Vincent K S Tay
Keyword(s):  
Breast Augmentation ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Patient Characteristics ◽  
Large Cell ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Capsular Contractures

Abstract Background Nanotextured breast implants were hailed as an innovation that may address capsular contracture and breast implant-associated anaplastic large cell lymphoma and may provide the sweet spot between smooth and conventional textured implants. Objectives This study aimed to evaluate the introduction of nanotextured implants alongside conventional textured implants and to compare early complications. Methods Patients who underwent breast augmentation from the introduction of nanotextured implants in the author’s practice with at least 1 year of follow-up were included. They were divided into nanotextured and conventional textured implant groups and then into 3 chronological subgroups. Patient characteristics, implant specifications, operative factors, and complication rates were compared. Results A total 415 cases with a mean follow-up of 26.9 months were identified, of which 38.8% utilized nanotextured implants and 61.2% conventional textured implants. Utilization of nanotextured implants increased from 26.9% in period 1 to 54.5% in period 3. Complication rates for the conventional textured group were 0.8% at 1 year and 3.5% on overall follow-up, with mostly capsular contractures; for the nanotextured group, complication rates were 6.8% and 8.7%, respectively, and “bottoming out” was most common. When analyzed across chronological subgroups, complication rates decreased for nanotextured implants by period 3. Conclusions A learning curve and associated complications are expected for early adopters of new implants. In our series, nanotextured implants were associated with higher complication rates at 1 year and on overall follow-up. Modifications in patient selection, intraoperative techniques, and postoperative care reduced complications in the later period. Level of Evidence: 4

Augmentation Mastopexy With Surgical Excision of the Lower Pole to Avoid Waterfall Deformity: A Surgical Technique and Nipple Areolar Complex Case Series

2020 ◽  
pp. 229255032093366
Author(s):  
Colin P. White ◽  
Brian D. Peterson
Keyword(s):  
Surgical Technique ◽  
Breast Augmentation ◽  
Capsular Contracture ◽  
Case Series ◽  
Senior Author ◽  
Complex Case ◽  
Silicone Implants ◽  
Lower Pole ◽  
Areolar Complex ◽  
Augmentation Mastopexy

Purpose of this article is to demonstrate a way of avoiding the waterfall deformity in augmentation mastopexy patients. We will show a case series of results and explain how this technique gives satisfying aesthetic results for patients seeking breast augmentation who also require mastopexy. We will show how addressing the breast parenchyma on the lower pole via direct excision can give reliable results and avoids the waterfall deformity. The surgical technique used by the senior author combines the principles of breast augmentation, mastopexy, and breast reduction. We apply these principles during the initial single operation. Our goal is to achieve the best anatomical results for the patient. We describe 1538 consecutive patients whom underwent single-stage breast augmentation with mastopexy. All implants were submuscular with 12% being saline and 88% were silicone implants. Vertical mastopexies were performed in 8% and wise pattern incisions were used in 92%. There were no life-threatening complications such as deep vein thrombosis, pulmonary embolism, and so on. Tissue-related complications included wound infection (1%) and hematomas (1%). Implant-related complications included malposition or implant displacement 9% and capsular contracture 1%. Aesthetic complications included dystopia of NAC (4%) and volume asymmetries (10%). Revision surgery was tissue related (2%), implant related (3%), and aesthetic related (10%). There were no cases of waterfall deformity seen in the cohort. In conclusion, we believe that the technique detailed here is easy to do, uses principles already known of breast augmentation and reduction and gives consistent results with low reoperation rates.

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.

scholarly journals Silicone Implant Versus Silicone Implant Assisted by Stromal Enriched Lipograft Breast Augmentation: A Prospective Comparative Study

Medicines ◽  
2020 ◽  
Vol 7 (5) ◽  
pp. 28
Author(s):  
Aris Sterodimas
Keyword(s):  
Patient Satisfaction ◽  
Breast Augmentation ◽  
Fat Grafting ◽  
Silicone Implant ◽  
Silicone Implants ◽  
Complication Rates ◽  
High Profile ◽  
Group A ◽  
Group B ◽  
Age Range

Background: Implant-assisted breast augmentation is among the most performed surgeries performed by plastic surgeons today. This prospective study evaluated the patient satisfaction and complication rates using high-profile round silicone implant alone (traditional breast augmentation) Group A versus the high-profile round silicone implant assisted with stromal enriched lipograft (composite breast augmentation) Group B. Methods: A total of 50 female patient candidates to undergo breast augmentation between January to September 2017 were randomly assigned to either group. The periareolar technique for breast augmentation and the subfascial plane were used in both groups for the insertion of the high-profile round silicone implants. The stromal enriched lipograft (SEL) was used in Group B for the preparation of the autologous fat grafting to the breast. The satisfaction of each patient with body appearance following breast augmentation was rated using an already published scale of 1–5. The rate of complications was analysed. Results: AS performed all the surgeries. In Group A, the age range was between 19 and 48 years (mean of 22.5 years). In Group B, the age range was between 20 and 47 years (mean of 24.1 years). The average BMI of Group A was 24 m/kg2 and 23 m/kg2 of Group B. Patient satisfaction meta-analysis for Group A and B at 12 months shows that patients in Group B expressed a satisfaction that is superior when compared to Group A patients. The ability to camouflage the implant could explain the higher satisfaction rates in Group B. The rate of complications appears similar in both groups. Conclusions: Composite breast augmentation using a combination of round high-profile implants and SEL in breast augmentation can achieve a higher patient satisfaction and aesthetic outcome as compared to the round high-profile breast augmentation alone. The technique is safe, simple and fast with low complication rates. Large multicentre, controlled, prospective studies need to be performed to further confirm the favourable results that were observed in this study.

scholarly journals Comprehensive Comparison Between Shaped Versus Round Implants for Breast Reconstruction: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 41 (1) ◽  
pp. 34-44 ◽  
Author(s):  
So-Eun Han ◽  
Kyeong-Tae Lee ◽  
Saik Bang
Keyword(s):  
Breast Reconstruction ◽  
Meta Analysis ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Relative Risks ◽  
Patient Reported ◽  
Aesthetic Results ◽  
Retrospective Cohort Studies

Abstract Background Prosthetic breast reconstruction has been gaining popularity and a variety of implant options are currently available. Therefore, it is important to evaluate the safety and efficacy of newly developed shaped implants compared with those of conventional round implants. To date, few studies have investigated the outcomes of breast reconstruction with shaped versus round implants. Objectives The present study aimed to comprehensively compare, via meta-analytic methodology, shaped and round breast implant reconstruction in terms of complication profiles and aesthetic satisfaction. Methods PubMed/MEDLINE, Ovid, and Cochrane databases were searched to identify relevant studies presenting the complication rates for shaped and round implant groups. The relative risks of the following complications between the groups were calculated: infection, seroma, capsular contracture, rupture, rippling, reconstruction failure, and implant exchange or removal. Outcomes of aesthetic satisfaction included aesthetic results and patient-reported outcomes. Results Meta-analysis of 8 retrospective cohort studies, representing 2490 cases of implant-based breast reconstruction, was performed. There were no significant differences in the risks of infection, seroma, capsular contracture, and reconstruction failure between the 2 groups. The risks of implant rupture and rippling were significantly reduced with shaped implants. In a subgroup analysis of shaped/textured and round/smooth implants, the risk of infection was significantly enhanced in the former, whereas incidences of other complications, including capsular contracture and reconstruction failure, were similar. Aesthetic satisfaction analysis of the 2 groups demonstrated similar outcome scores with favorable overall results. Conclusions Our results suggest that both shaped and round implants might provide favorable breast reconstruction outcomes with similarly low complication rates and aesthetic results. Level of Evidence: 4

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.

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