A Single Center's Clinical Experience With Ergonomix Breast Implants

Background This retrospective study reports on the early experience of a private surgical center with Motiva Ergonomix SilkSurface SikSurface breast implants. Objectives to examine the incidence of complications and satisfaction levels in women who received primary and revision breast augmentation or augmentation-mastopexy with this device. Methods 356 consecutive patients received Motiva Ergonomix breast implants from April 2014 to October 2018 by 3 different surgeons and were followed-up for a minimum of 12 months. Complications were assessed by measuring the rate of rupture, capsular contracture, malposition, late seroma, double capsule, reoperation, symmastia, ptosis, extrusion, and infection. Satisfaction with aesthetic results was assessed by both surgeon and patient, using the Likert scale. Results Only six major complications were observed in these 356 patients (712 implants). One unilateral implant ptosis (“bottoming out”) at 12 months (0.14 %) and 2 capsular contractures (0.28 %), one at 14 months and the other at 2 years. At all time-points, 98% of the patients were “extremely satisfied or very satisfied” with the aesthetic results and surgeons categorized the outcomes as “very important or important improvement” in 96% of the cases. Conclusions Motiva Ergonomix SilkSurface devices provided high patient satisfaction up to more than 5 years postoperatively with very few complications. These data are consistent with other reports in the literature. The observed favorable outcomes might be attributed, at least in part, to Motiva Ergonomix’s bio-engineered “cell-friendly” surface.

Radiation therapy and breast reconstruction

Radiation therapy is an integral component of the treatment of breast cancer. Although its implementing after breast reconstruction sufficiently increases the number of complications, particularly capsular contractures. After having analyzed published materials and meta-analysis research the authors made a conclusion – if a patient is planned to have a breast reconstruction, it’s better to make it with her own tissue. On the other hand the risk of capsular contractures development significantly decreases when using acellular matrix and polyurethane shell to cover the implant. This fact gives hope that conflict between breast reconstruction and the necessity of the radiation therapy can be solved.

Generation of secondary radiation on the surface of endoprostheses used for breast reconstruction during mastectomy, after radiation therapy

Objective: Experimental estimate of the secondary radiation on the surface of implants and expanders, used for breast reconstruction in case of mastectomy, after making radiation therapy.Methods: Special equipment was constructed by radiation study department. It consists of linear accelerator as a source of ionizing radiation and a gamma-ray spectrometer with the detector on the basis of ultrapure germanium. The objects of research were the implants and expanders of the different producers.Results: The maximum amount of the secondary photons on the implants and expanders was generated on the energy level lower than 700 KEV. The level of photons’ generation between 600–300 KEV was higher on the surface of the implants than on the surface of expander filled with saline.Conclusion: The photons of the secondary radiation with the energy level from 100 to 700 KEV are generated under the influence of ionizing radiation on the implants and tissue expander filled with saline. It can be one of the causes of capsular contractures development after mastectomy.

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

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

A Novel Technique for Treatment of Recurrent Capsular Contracture Using Acellular Dermal Matrix in Aesthetic Revisional Breast Surgery

Capsular contracture remains among the most commonly cited reasons for reoperation following implant-based breast augmentation. The introduction of acellular dermal matrix (ADM) in revision surgery has led to a decrease in the recurrence of capsular contracture. However, there remains a relative paucity of literature in secondary aesthetic surgery and its use is associated with increased patient costs. The authors describe a novel technique using segmental interpositional graft placement to treat and prevent contracture recurrence while decreasing additional costs to the patient. This study is a retrospective chart review of patients who presented with recurrent capsular contractures and underwent revision surgery by a single surgeon. Patient demographics, treatment history, and postoperative complications were recorded. Five patients (7 breasts) were identified. Mean age was 36 years old and mean body mass index was 20.6 kg/m2 (range, 18.1-24.6 kg/m2). All 5 patients had prior surgical treatment for capsular contractures with recurrence. Mean follow-up was 52.8 months (range, 36-60 months). One patient experienced a recurrence in an untreated pole of the breast. The remaining patients did not experience recurrent capsular contracture to date. Multiple studies have shown the benefit of using ADM in the prevention or treatment of capsular contracture. The author’s technique may be an effective strategy to treat recurrent capsular contractures while decreasing the patients’ out-of-pocket costs.