Saline-Filled Breast Implants: A Plastic Surgery Educational Foundation Multicenter Outcomes Study

Gutowski, K.A.; Mesna, Gregory T.; Cunningham, Bruce L.

doi:10.1097/00006534-199709001-00028

Cited by 142 publications

(78 citation statements)

References 20 publications

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“…Readmissions after breast augmentation result mainly from implant failure. 18 The low return rate after cataract extraction and other types of eye surgery is also compatible with previously published rates. 19 These procedures are relatively short in duration (Ͻ1 hour); they are usually completed under monitored anesthesia care, resulting in a low rate of anesthesiarelated symptoms; and they are usually less painful procedures, causing postoperative discomfort for only a limited time.…”

Section: Discussionsupporting

confidence: 88%

Return Hospital Visits and Hospital Readmissions After Ambulatory Surgery

1999

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ObjectiveTo determine the overall and complication-related readmission rates within 30 days after ambulatory surgery at a major ambulatory surgical center. Summary Background DataCurrently in North America, 65% of the surgical procedures are carried out in ambulatory settings. The safety of ambulatory surgery is well documented, with low rates of adverse events during or immediately after surgery. The consequences of ambulatory surgery during an extended period, however, have not been studied extensively. MethodsPreoperative, intraoperative, and postoperative data were collected on 17,638 consecutive patients undergoing ambulatory surgery at a major ambulatory surgical center in Toronto, Ontario. With the use of the database of the Ontario Ministry of Health, the authors identified all return hospital visits and hospital readmissions occurring in Ontario within 30 days after the ambulatory surgery. Return visits were categorized as emergency room visits, ambulatory surgical unit admissions, or inpatient admissions. The readmissions were categorized as those resulting from surgical, medical, or anesthesia-related complications or those not related to the ambulatory surgery. ResultsOne hundred ninety-three readmissions occurred within 30 days after ambulatory surgery (readmission rate 1.1%). Six patients returned to the emergency room, 178 patients were readmitted to the ambulatory surgical unit, and 9 patients were readmitted as inpatients. Twenty-five readmissions were the result of surgical complications, and one resulted from a medical complication (pulmonary embolism). The complication-related readmission rate was 0.15% (1 in 678 procedures). The complication rate was significantly higher among patients undergoing transurethral resection of bladder tumor (5.7%). No anesthesia-related readmissions or deaths were identified. ConclusionsThe rate of complication-related readmissions was extremely low (0.15%). This result further supports the view that ambulatory surgery is a safe practice.

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Section: Discussionsupporting

confidence: 88%

Return Hospital Visits and Hospital Readmissions After Ambulatory Surgery

1999

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“…With subfascial placement Ventura and Marcello [77] found only 2% of patients were graded Baker II. Finally, Gutowski et al published data reporting that the subglandular position increased risk eight-fold for developing capsular contracture [78]. This said, some have found no significant association [79].…”

Section: Capsular Contracture: Possible Aetiological Background Theormentioning

confidence: 99%

A literature review and summary of capsular contracture: An ongoing challenge to breast surgeons and their patients

Malahias

Jordan

Hughes

et al. 2016

International Journal of Surgery Open

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A B S T R A C TCapsular contracture is a significant difficulty where implants are used in both breast augmentation and breast reconstruction surgery. This report reviews the published literature focusing on factors and techniques that reduce the incidence of this complication, as well as evaluating the available treatment options for patients who have developed a contracture.A search of the MEDLINE database for clinical studies involving the understanding, diagnosis and management of capsular contracture was performed, with 106 articles deemed relevant for this review. Our search criteria included observational studies as we wish to discuss and highlight the areas of this condition that have been investigated, and unfortunately there is limited clinical evidence in regard to high quality trials in this field.Risk factors for capsular contracture are multi-factorial, and all surgeons should aim to minimise these as much as possible both intra-and peri-operatively. However, in high risk patients it is not achievable to completely remove these elements. When capsular contracture does develop, there are currently only a limited number of surgical options including capsulotomy, capsulectomy with or without reimplantation, or reconstruction with autologous tissue. These procedures, as well as the original implant surgery, ought to be discussed with patients on an individual basis, taking into account their personal needs and expectations.The future of this complication may lie in the development of pharmaceutical interventions, and recent studies have shown promising results. Although this field requires more research, the effectiveness of some new pharmaceutical approaches, to provide alternative non-surgical options for patients with capsular contracture, can only aid both patients and the breast surgeon.

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“…9,10 Deflation occurred especially in the former breast implant model 1800 with an unacceptable high incidence. [11][12][13] It was significantly reduced after 1984, when the valve system was modified.…”

Section: Resultsmentioning

confidence: 99%

Saline Implants-Where Are We?

Menke¹,

Germann²

2000

Perspectives in Plastic Surgery

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Saline-filled implants have been used for more than 30 years, until 1992 not very often, but after the U.S. Food and Drug Administration moratorium nearly exclusively in the United States. Experiences with these implants increased considerably with about 70,000 implants per year. Based on the actual literature the results available about saline implants were analyzed. The incidence of implant failure by deflation is about 5 to 15%, significantly reduced compared with former results, and depending mostly on the length of follow-up. Up to now there is no clear standard for the ideal fill volume to avoid the complication of wrinkling or unnatural firmness. The discussion about the best way to avoid the high incidence of capsular contractures, optimal implant position, and texture and structure of the shell is also still going on controversially.

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Saline-Filled Breast Implants: A Plastic Surgery Educational Foundation Multicenter Outcomes Study

Cited by 142 publications

References 20 publications

Return Hospital Visits and Hospital Readmissions After Ambulatory Surgery

Return Hospital Visits and Hospital Readmissions After Ambulatory Surgery

A literature review and summary of capsular contracture: An ongoing challenge to breast surgeons and their patients

Saline Implants-Where Are We?

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