Does Overfilling Smooth Inflatable Saline-Filled Breast Implants Decrease the Deflation Rate? Experience with 4761 Augmentation Mammaplasty Patients

Abstract

Background Research suggests that overfilling saline inflatable breast implants may decrease their deflation rates. To date, there has been no large-scale study comparing breast implants filled within vs. beyond the manufacturer’s recommended fill volumes. Methods A retrospective comparative study was conducted for 4761 women who underwent aesthetic augmentation mastopexy by the author. Patients were divided into two groups: Group 1 includes 2960 patients who had breast augmentation between 2002 and 2009 with implants filled within the manufacturer’s recommended fill volumes. Group 2 includes 1801 patients who had breast augmentation between 2011 and 2018. Their implants were overfilled with an average volume between 42 and 50 cc, or 10–13%, respectively. All surgeries were performed with Mentor Style 1600 saline breast implants (smooth, round moderate profile) through an inframammary incision; implants were placed in the subpectoral (dual) plane. Also evaluated was the yearly increase in deflation rates. Results Group I had 119 deflations, representing a deflation rate of 4.02%. Group 2 had 33 deflations, providing a deflation rate of 1.83%. The author found a protective effect in overfilling the device (p < 0.00001 and Z-score of 4.17). Fold failure was the major reason for deflation in both groups. The implants filled within the manufacturer’s recommended volume had a yearly increase in deflation rate of 0.41%, not 1% as is commonly reported. The overfilled implants did not have a yearly increase in deflation rate. Conclusion Overfilling Mentor Style 1600 saline breast implants (smooth, round moderate profile) 10–13% significantly reduced the deflation rate. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Optimizing Breast Implant Outcomes: MemoryGel Xtra Implants and Future Research Directions

“…With regard to deflation rates, a study done by Eisenberg showed that females with breast implants filled above the manufacturers recommended fill volumes as opposed to those within the recommended fill volumes showed a significantly reduced deflation rate. 3 Furthermore, in another study done by Al-Sabounchi, it was shown that filling Mentor 2600 prostheses to a level above the recommended guidelines led to increased longevity of the breast implants and as well had a significant effect on the 10-year survival rate of the implants. 2 Future research into determining the optimal levels for shell filling of MemoryGel Xtra implants and their impact on various complications can potentially contribute to increased overall performance of breast implants and can guide the development of even more advanced and tailored devices.…”

“…This concept is grounded in experiences with saline-filled implants, with which maximal filling has been associated with reduced wrinkling and rippling and a prolonged implant life span. 3 The design of MemoryGel Xtra implants incorporates this idea, optimizing gel fill to enhance central device fullness and projection while minimizing surface wrinkling. The authors express their expectation that continued observation over the next 7 years will reveal whether these precision-filled implants indeed lead to enhanced long-term results.…”

Optimizing Prepectoral Implant Placement and Concomitant Fat Grafting After Tissue Expansion

“…For the last 40 years, the predominant approach has been to place the tissue expander and implant deep to the pectoralis major muscle, often requiring mobilization of serratus anterior and rectus abdominis fascial flaps to provide lateral and inferior implant coverage, respectively 2–4 . Subpectoral tissue expanders are often overfilled to enhance breast projection 5 . Despite satisfactory implant coverage, support, and cosmetic outcomes, the subpectoral approach poses risks from pectoralis elevation including pain, animation deformity, implant lateralization, poor inframammary fold definition, and revision rates as high as 30% 4,6,7 .…”