A Comparison of Conventional and Low-Bleed Implants in Augmentation Mammaplasty

Chang, Lawrence; Caldwell, Elethea H.; Reading, George; Wray, Christie R.

doi:10.1097/00006534-199201000-00015

Cited by 6 publications

(7 citation statements)

References 0 publications

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“…10,11,14,15 Capsular contracture is typically apparent within the first year after implantation, 7,9,14,15 and is likely to mature with time, with accumulating risks over the lifetime of the implant, 16 -18 but the exact etiology and frequency based on modern devices is unknown. Numerous studies have examined the influence of implant filler material, surface texture, silicone bleed, and implant placement on capsular contracture, 13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] but the findings are contradictory, which may be explained in part by different study designs, indications for surgery, implant types, and length of follow-up, as well as by variations in outcomes of interest (capsular contracture Baker II-IV vs III-IV) and whether analyses were done at breast level or woman level. In a study of symptom reporting by women with cosmetic implants, saline implant, subglandular placement, smooth surface, and postoperative hematoma were associated with increased risk of capsular contracture.…”

Section: Discussionmentioning

confidence: 99%

Surgical Intervention and Capsular Contracture After Breast Augmentation

Henriksen¹,

Fryzek²,

Hølmich³

et al. 2005

Annals of Plastic Surgery

184

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Epidemiologic data on local complications after breast augmentation are scarce. In particular, few prospectively collected data are available on modern breast implants on this issue. Using data from the Danish Registry for Plastic Surgery of the Breast, the authors examined determinants of surgery-requiring complications and capsular contracture grades III to IV among 2277 women who underwent cosmetic breast implantation from June 1999 through April 2003. During an average follow-up period of 1.6 years after implantation, 4.3% of these women (3% of implants) required secondary surgery as a result of short-term complications. The most frequent clinical indications for surgery were displacement of the implant (38%), capsular contracture grades III to IV (16%), ptosis (13%), and hematoma (11%). Overall, the authors found that inframammary incision and subglandular placement were associated with decreased risks of developing complications requiring surgical intervention, whereas implants larger than 350 mL increased the risk of such complications (relative risk [RR], 2.3; 95% confidence interval [CI], 1.3-4.0). Thirty-nine Baker III to IV capsular contractures were identified, of which 22 were treated surgically within the study period. Submuscular placement of the implant decreased the risk of capsular contracture grades III to IV (RR, 0.3; 95% CI, 0.2-0.8), whereas surgical routes other than inframammary and drainage of implant cavity were associated with increased risk of capsular contracture. Current surgical practices and modern implants used for breast augmentation produce fewer short-term complications than procedures and devices of the past. This prospective study indicates that surgical procedures are more important predictors for local (short-term) complications than implant or patient characteristics.

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Section: Discussionmentioning

confidence: 99%

Surgical Intervention and Capsular Contracture After Breast Augmentation

Henriksen¹,

Fryzek²,

Hølmich³

et al. 2005

Annals of Plastic Surgery

184

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“…Contour deformity, caused by capsula contracture or capsula atrophy, is also a problem. [2][3][4] When the total muscle coverage of the prosthesis is not possible, the use of a local or regional flap supplements the muscle deficit, especially at the inferolateral breast pole. 5 This extended procedure is associated with its own set of problems.…”

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confidence: 99%

Implant Breast Reconstruction Using Acellular Dermal Matrix

Gamboa-Bobadilla

2006

Annals of Plastic Surgery

198

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Thirteen breast reconstructions in 11 patients, averaging 58 years of age, underwent mastectomies. The technique uses a saline implant either totally or partially covered with a human acellular dermal matrix. The mean postoperative follow-up time was 14 months. Ninety percent of the patients were considered high risk; the thickness of the human acellular dermal matrix was an average of 1.3 mm, with an average area per breast of 121 cm. There were 12 successful breast reconstructions (92%) that provided stability, increased soft tissue padding, which allowed a greater resemblance to normal breast shape and decreased rippling and implant visibility. The graft was used in an onlay fashion or as an extension of the pectoralis major muscle that covers the implant. A representative histologic cross-section of well-integrated human acellular dermal matrix is presented. The use of a human acellular dermal matrix in breast reconstruction is an alternative protocol in high-risk patients, resulting in a minimal increase in operative time and a decrease in morbidity compared with more extensive procedures.

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“…Their influence on the enzymatic transformation of silicone to silicon dioxide as the triggering occurrence for an immunologic answer has been discussed on many occasions. 17,40,41 There is a consensus that subclinical infections stand in direct correlation with the development of capsular fibroses. 4 …”

Section: Pathophysiology Of Capsular Fibrosismentioning

confidence: 99%

“…4 The reasons that have led to the occurrence of capsular fibrosis have been a cause of controversy for a long time. [5][6][7][8] Apart from clinical and subclinical infections 9 -11 and seroma and hematoma, reactions to the surface [12][13][14][15] and the filling material 16,17 have long been considered to be the promoting factors. The surface properties of silicone lead to a tissue reaction that portrays a histologic appearance of connective tissue deposition on the frontier between the implant and the tissue itself.…”

mentioning

confidence: 99%