Breast implants have evolved from the original saline-filled, smooth-surfaced silicone rubber bag to silicone gel-filled smooth-walled sacs to a combination of a silicone gel-filled bag within a saline-filled sac, and, most recently, a reversed, double-lumen implant with a saline bag inside of a gel-filled bag. Texture-surfaced implants were first used in 1970 when the standard silicone gel-filled implant was covered with a polyurethane foam. Because of concerns about the degradation products of this foam, they were removed from the market in 1991. In 1975 double-lumen silicone textured implants were developed, followed by silicone gel-filled textured implants. In 1990 a new radiolucent, biocompatible gel was produced that reduced the problem of radioopacity of silicone implants. Because of the gel's sufficiently low coefficient of friction, leakage caused by fold flaw fracture may also be decreased. We present a case where this new biocompatible gel implant was repositioned after four months. The resulting scar capsule in this soft breast was thin [< 0.002 cm (0.008 in.)] and evenly textured as a mirror image of the textured silicone surface. Scanning electron microscopy and x-ray defraction spectrophotometry revealed no silicone bleed.
Most investigators consider the caroticotympanic artery to be a normal branch of the petrous portion of the internal carotid artery, although some authors disagree. The present study was conducted on forty human temporal bones removed from adult cadavers of both sexes. Twenty pieces were injected and dissected under a surgical microscope, 10 pieces were injected and submitted to corrosion, and 10 were injected and diaphanized in order to observe the frequency of the caroticotympanic artery in the petrous portion of the internal carotid artery. The caroticotympanic artery was not observed in any of the pieces submitted to microdissection and was observed in only 1 of the pieces (10%) submitted to corrosion and also in 1 of the diaphanized pieces (10%). In both cases, only one artery was present. Based on the present results showing that the rate of occurrence of the caroticotympanic artery was very low by the three techniques utilized (microdissection 0%; corrosion 10%; diaphanization 10%), it is possible to conclude that, anatomically, the artery should be considered as a variation and not as a normal branch of the petrous portion of the internal carotid artery, in agreement with most literature reports.
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