A 15-Year Experience with Primary Breast Augmentation

Codner, Mark A.; Mejia, Juan Diego; Locke, Marius; Mahoney, Amy; Thiels, Cornelius A.; Nahai, Farzad R.; Hester, T. Roderick; Nahai, Foad

doi:10.1097/prs.0b013e318205f41b

Cited by 134 publications

(65 citation statements)

References 24 publications

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“…The U.S. FDA defines ''reoperation'' as any additional breast surgery a patient may undergo [10]. Only cases in which the primary augmentation was performed via the transaxillary approach were included.…”

Section: Methodsmentioning

confidence: 99%

“…They include but are not limited to capsular contracture, seroma, axillary scarring, asymmetry, undesirable waviness, and palpability and leakage or rupture of the implant [7,8]. The incidence rates of these complications vary widely among the several articles on the subject [9,10] and depend on the experience of the surgeon with a particular technique. Many reports documented the efficacy of the axillary approach as an incision option [1,2].…”

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confidence: 96%

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Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Basile

2011

Aesth Plast Surg

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Section: Methodsmentioning

confidence: 99%

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confidence: 96%

Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Basile

2011

Aesth Plast Surg

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“…11, 12 Codner et al 13 performed 634 primary breast augmentations and 178 mastopexy-augmentations over a 15-year period. The most common complication was CC at 8.2%, followed by rippling in 7.1% of patients.…”

Section: Discussionmentioning

confidence: 99%

Why Do Patients Seek Revisionary Breast Surgery?

Grewal

Fisher

2013

Aesthetic Surgery Journal

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In 2011, according to the American Society for Aesthetic Plastic Surgery (ASAPS), 316 848 American women underwent breast augmentation and 112 964 underwent breast reduction surgery.1 These 2 procedures rank in the top 10 among all procedures (surgical and nonsurgical) performed annually. Breast surgery patients desire symmetry, softness, and longevity of results. Over a lifetime, the majority of those breast surgery patients who do seek secondary revisions are attempting to correct ptosis, capsular contracture (CC), malposition, or simply to make a change in size and shape.With reoperation, there is an increased risk of complication, and good cosmetic outcomes may be difficult to achieve.2,3 Correcting the problem requires an understanding of the primary operation and the endurance of the Why Do Patients Seek Revisionary Breast Surgery? Navanjun S. Grewal, MD; and Jack Fisher, MD Abstract Background: Patient motivations for revisionary breast surgery following breast augmentation, mastopexy-augmentation, and breast reduction are often overlooked. Most patients presenting for a revision do so because they desire a subsequent improvement in their appearance or wish to correct a problem resulting from the primary operation.Objective: We present and analyze the clinical indications for revisionary breast surgery in a series of 134 consecutive cases. Methods: We retrospectively reviewed the charts of 134 patients who underwent revisionary breast surgery in a single clinic from 1994 to 2009. Patients were grouped based on operative procedure: augmentation (n = 110), mastopexy-augmentation (n = 10), bilateral breast reduction (n = 15), breast malformation correction (n = 1). Three categories were also specified according to the cause for secondary surgery: (1) the surgeon's operative plan was flawed and/or involved a technical error, (2) an independent factor occurred such as ptosis or capsular contracture, or (3) there was a combination of both factors. Results: The most frequent reasons for revisionary surgery among aesthetic implant patients were the development of ptosis (42%), capsular contracture (29%), and lower-pole deformities (19%). Twenty-six percent of patients had a combination of problems. Revision among breast reduction patients was due to volume loss from overresection (40%), nipple-areola loss (27%), and breast asymmetry (27%). The average time between the first surgery and reoperation was 8.9 years for augmentation, 4.3 years for mastopexy-augmentation, and 2.9 years for reduction. In implant patients, the biggest problem leading to revisionary surgery was natural progression (66% augmentation, 90% mastopexy-augmentation). However, among breast reduction patients, 73% of revision requests were a result of problems with surgeon judgment or technique. Conclusions: Our study demonstrates that although the rate of surgeon-specific problems was high in reduction patients, overall, independent factors were the primary reason patients sought revisionary breast surgery. This may be contrary to commonly held ...

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“…In addition, information on implant characteristics was available only at time of implantation and we did not ascertain if augmented women went through a reoperation to modify or replace their implants. In fact, recent studies have reported reoperation rates ranging from approximately 20% to 30% after 6 years of follow-up following breast augmentation surgery (72)(73)(74)(75). Thus, reoperation may have prevented the identification of associations of some implant characteristics with stage or mortality if characteristics of the subsequent implants are different from those of the initial implants.…”

Section: Principal Findings and Comparison With Previous Studiesmentioning

confidence: 99%

Do Breast Implants Adversely Affect Prognosis among Those Subsequently Diagnosed with Breast Cancer? Findings from an Extended Follow-Up of a Canadian Cohort

Lavigne

Holowaty

Pan

et al. 2012

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Cosmetic breast implants may impair the ability to detect breast cancers. The aims of this study were to examine whether implants and implant characteristics are associated with more advanced breast tumors at diagnosis and poorer survival.Methods: Study population includes all invasive breast cancer cases diagnosed during follow-up of the large Canadian Breast Implant Cohort. A total of 409 women with cosmetic breast implants and 444 women with other cosmetic surgery were diagnosed with breast cancer. These women were compared for stage at diagnosis using multinomial logistic regression models. Cox proportional hazards regression models were used for breast cancer-specific mortality analyses. Comparisons were also conducted according to implant characteristics.Results: Compared with women with other cosmetic surgery, those with cosmetic breast implants had at later stage breast cancer diagnosis (OR of having stage III/IV vs. stage I at diagnosis: 3.04, 95% confidence interval (CI): 1.81-5.10; P < 0.001). A nonstatistically significant increase in breast cancer-specific mortality rate for women with breast implants relative to surgical controls was observed (HR ¼ 1.32, 95% CI: 0.94-1.83, P ¼ 0.11). No statistically significant differences in stage and breast cancer mortality were observed according to implant characteristics.Conclusions: At diagnosis, breast cancers tended to be at more advanced stages among women with cosmetic breast implants. Breast cancer-specific survival was lower in these women although the reduction did not reach statistical significance.Impact: Further investigations of the effect of breast implants on breast cancer prognosis are warranted. Cancer Epidemiol Biomarkers Prev; 21(10); 1868-76. Ó2012 AACR.

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A 15-Year Experience with Primary Breast Augmentation

Cited by 134 publications

References 24 publications

Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Why Do Patients Seek Revisionary Breast Surgery?

Do Breast Implants Adversely Affect Prognosis among Those Subsequently Diagnosed with Breast Cancer? Findings from an Extended Follow-Up of a Canadian Cohort

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