Screening mammography in 350 women with breast implants: prevalence and findings of implant complications.

Destouet, J M; Monsees, Barbara; Oser, Rachel; Nemecek, J R; Young, V. Leroy; Pilgram, T K

doi:10.2214/ajr.159.5.1414810

Cited by 78 publications

(27 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In other patients without dissemination of gel outside the fibrous capsule mammography report did not indicate implant rupture. The same findings were described previously [2,5,7].…”

Section: Discussionsupporting

confidence: 81%

Findings in the removal of silicone gel breast implants: a correlation between time of implantation and rupture

Marques¹,

Brenda²,

Amarante³

et al. 1997

Eur J Plast Surg

View full text Add to dashboard Cite

Abstract. Thirty-eight patients underwent surgical removal of their smooth silicone gel breast implants. In 22 cases the implants had been inserted for aesthetic augmentation, and in 16 for reconstruction. Twelve of the reconstructed patients had a simple mastectomy, four had a modified radical mastectomy with latissimus dorsi flap reconstruction. The time between implantation and removal was from three months to 18 years, with a mean of 8.75. Sixty-two implants were removed of which 33 were intact, 17 leaking, and 12 ruptured. Fifteen intact implants were removed in the first five years and 18 from five to ten years; no implant had been in place for more than ten years. In those implants where there was leakage (n=17), two were removed in the first five years, four from five to ten years, and 11 after ten years. None of the implants removed during the first five years of implantation were ruptured. Nevertheless, rupture was detected in three implants removed from five to ten years, and in nine removed after ten years. Thus, the 20 implants removed after 10 or more years of implantation showed some form of damage to their outer shell. These findings suggest that a thorough follow-up is mandatory in patients having silicone gel breast implants for more than five years. Key words: Silicone elastomers -Breast reconstruction -Breast -Plastic surgery -ImplantsThe moratorium on silicone gel breast implants put in effect by the FDA on November 1991 raised considerable controversy, in which the main concern was that it had been too hasty a decision. It was based upon reports of asymptomatic rupture and diagnosis of immunological diseases related to silicone implantation [8]. After only a few years, a growing number of reports have appeared in the literature describing complications related Since then a large number of patients have undergone removal or substitution of their implants. The concern that drives these patients is shared by their physicians and that has led to more detailed observations and documentation of operative findings. It is 30 years since augmentation was begun, thus the long-term outcome of such procedures can now be evaluated [4,6].The present study is a retrospective analysis of patients who had implants removed, the structural changes of these implants to the length of their implantation time. In this series all implants in place for more than ten years had structural damage. Material and methodsThirty-eight patients had 62 smooth removed and exchanged silicone gel implants between 1979 and 1993. The patients were 28 to 69 years old, with a mean of 46 years. Fifty-eight percent (22/38) were for augmentation and 42% (16/38) for reconstruction. The patients presented with the complaint of capsular contracture, pain, spontaneous change in breast shape, desire to improve the breast shape, or to increase size (Table 1). There were no systemic symptoms of complaints such as arthritis, myalgia, asthenia, thyroid or liver disorders. The time elapsed from implantation varied from three months to 18 years. ...

show abstract

“…In other patients without dissemination of gel outside the fibrous capsule mammography report did not indicate implant rupture. The same findings were described previously [2,5,7].…”

Section: Discussionsupporting

confidence: 81%

Findings in the removal of silicone gel breast implants: a correlation between time of implantation and rupture

Marques¹,

Brenda²,

Amarante³

et al. 1997

Eur J Plast Surg

View full text Add to dashboard Cite

show abstract

“…Mammography is ideal for breast parenchymal evaluation and obvious extracapsular silicone implant rupture. It fails, however, to consistently detect intracapsular implant rupture [36,37].…”

Section: Radiologicalmentioning

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

View full text Add to dashboard Cite

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.

show abstract

“…In some series, this has been a serious clinical problem. 7,8 Questions have been raised and theories proposed to address the relationship between silicone based implants and various connective tissue disorders identified in women with breast implants. 9,10 Published reports have recorded symptoms of autoimmune disease in patients following silicone breast implant insertion.…”

Section: Introductionmentioning

confidence: 99%

The peri-implant breast capsule: An immunophenotypic study of capsules taken at explantation surgery

Kamel

Protzner

Fornasier

et al. 2001

J. Biomed. Mater. Res.

View full text Add to dashboard Cite

Silicone-based breast implants continue to be the focus of many studies attempting to correlate implant failure to clinical and pathological factors. Routine pathology of peri-implant capsule is extensively described in the literature. The actual significance of the cellular events remains unconfirmed, particularly with reference to clinical outcome. This study reviews our experience with explanted capsules. The study makes specific reference to the immunohistochemistry of the cells participating in the capsule and the significance of the immunophenotypic characterization of these cells to clinical outcome. The use of a wide selection of immunomarkers for T and B lymphocytes and histiocytes provided no supporting evidence for local cell participation in the capsule, which may indicate the presence of an immunological reaction present in the capsule at the time of explantation. One was only able to confirm the presence of a low grade inflammatory process and progression to fibrosis and calcification over time. Statistical correlation was obtained only between Baker grade of capsular contracture and CD3/CD68 immunomarker positivity. CD45RO did show correlation with pain. No correlation was demonstrated with calcification. The results obtained in this study highlighted the need for further investigations into the mechanism of histiocyte and fibrocyte recruitment and activation in the capsule, a possible source of pain and contracture, which is a serious long-term clinical finding leading to the necessity for explantation.

show abstract

Screening mammography in 350 women with breast implants: prevalence and findings of implant complications.

Cited by 78 publications

References 1 publication

Findings in the removal of silicone gel breast implants: a correlation between time of implantation and rupture

Findings in the removal of silicone gel breast implants: a correlation between time of implantation and rupture

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

The peri-implant breast capsule: An immunophenotypic study of capsules taken at explantation surgery

Contact Info

Product

Resources

About