Injections of PAAG can cause irreversible damage to the breast necessitating complex debridement procedures, even mastectomy and breast reconstruction. Despite numerous surgical interventions, gel remnants are still found on subsequent breast imaging. Although PAAG is prohibited in many countries, different types of injections with unknown long-term effects are currently being used. Making the public aware of the problems of injectables for breast augmentation is warranted.
A suspicious breast mass was intra-operatively found in a female patient previously operated for breast augmentation with the Poly Implant Prothèse (PIP) implants. The neoplasm was verified as xanthoma and an asymptomatic microrupture of PIP was also detected. This report discusses possible association of breast xanthoma with PIP implant rupture.
The aim — to determine the effectiveness of the upper pole reinforcement of «neo pocket» with prolene thread for the mammary gland prothesis rotation (MGPR) prevention after primary augmentative mammoplasty in the remote postoperative period.Materials and methods. A prospective independent comparison of annual results after primary augmentation mammoplasty in two groups of patients was carried out. The comparison group included 94 patients, the main group — 76 women, whose operation was accompanied by fixing the upper pole of the «neopocket» with the prolene mesh. Any statistical differences were not found between the two groups in age, body mass index, mass of breast prostheses, the proportion of patients who were pregnant and breast‑fed. In all cases, the implanted textured prosthesis was with a high and medium profile. Most patients had prostheses in the volume of 325 — 335 and 375 ml. The evaluation of the MGPR was carried out following the developed procedure with the ESAOTE ultrasound device, the Technos Partner model, by a linear sensor with a frequency of 12.5 MHz.Results and discussion. The comparison group, showed 143 (76.1 %) prostheses being rotated, whereas the main group — 46 (30.3 %) (p = 0.001). In the comparison group, only 4 (1.6 %) women did not have RP of both glands, in the main group — in 39 (51.3 %) (p = 0.001). Significant differences in the degree of MGRP (p = 0.001) were noted due to the absence of angles 120°, 150° and 180° in the main group of the LLP. The main group did not demonstrate even a single case of clinically significant MGPR, while in the comparison group 11 (11.7 %) (p = 0.002). In the main group, the ratio of 30°/60 ° rotation (10.9 and 89.1 %) statistically significantly differed from that in the comparison group (31.5 and 68.5 %) due to a smaller proportion of MGPR at 60° (p = 0.006).Conclusions. A method of fixation of the submuscular «neo pocket» upper pole with prolene mesh a year after the augmentative mammoplasty, avoids clinically significant MGPR (more than 900) in contrast to the traditional method (11.7 %) (p = 0.002), and in cases of clinically insignificant rotation to decrease in 1.3 times the proportion of prostheses rotation at 600 (p = 0.006).
Relevance. Using anatomical breast implants with high and ultrahigh profile in augmentation mammoplasty provides nearly natural shape of breasts. Using the drop-like shape implants instead of round ones can cause complication called breast implant rotation (BIR), that have negative influence on patients life quality. There is not enough data about the effective methods of surgical treatment of clinically significant rotation. Objective of our study was to determine the effectiveness of «neo pocket» upper pole inhancement with mesh for the treatment of BIR after primary submuscular breast augmentation in a postoperative period. Materials and methods. The study included 42 women with an average age of 29.4 ± 0.7 years (20 to 39 years) who underwent surgery for a clinically significant (more than 90o) BIR that occurred after the classical primary breast augmentation. Treatment of BIR was performed by enhancement of upper pole of neo-pocket redublication of implant capsule with prolene mesh between the capsule layers and fixation to ribs periosteum and pectoral muscules. The endpoint of the study was the frequency and degree of the prosthesis rotation one year after BIR treatment. Data analysis was performed using the IBM SPSS Statistics 22. Results. 13 (31,0%) of patients admitted to hospital for prothesis enlargment and BIR – 29 (69,0%). From 84 number of implants 66 (78,6%) were rotated. Two women (4,7%) had same degree of implants rotation. In all other cases BIR had different angle. Clinically significant rotation of implants was diagnosed in 4 patient: 90 ° / 90 ° two patients; 90° / 150° – one patient ; 90° / 180° – one patient. 38 (90,5%) patients had clinically significant implants rotation. In one year after primary surgery significant BIR (90%) was diagnosed in one patient, who didn’t need breast augmentation, she also had a small rotation of breast on 60о before surgery. From number of breasts, when developed procedure was performed (56), in one case significant BIR was diagnosed, in a patient with preoperative BIR 1800. Significant BIR was diagnosed in 6 (11,5 %) patients, and one patient BIR 60о (1,8 %) and five 300 (8,9%). Conclusion: The developed method of «neo pocket» upper pole enhancement by redublication of prothesis capsule with prolene mesh between the capsule layers and fixation to ribs periosteum and pectoral muscules helps to avoid BIR in 98,2% in one year follow up period.
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