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Breast Implant Stability in the Subfascial Plane and the New Shaped Silicone Gel Breast Implants

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Abstract

The author presents his experience with breast augmentation using a next-generation, form-stable, anatomically shaped silicone gel breast implant. Rotation is a potential complication for anatomically shaped breast implants. Anatomically shaped saline implants have been reported to have a rotation rate as high as 14%, while lower rotation rates of 1–2.6% for anatomic cohesive gel silicone implants have been reported. Currently, these implants are limited in the United States to US FDA-approved clinical trials. The author reviews the appropriate surgical techniques to prevent rotation when using these devices. A recent innovation, placement of the superior pole of the implant underneath the superficial fascia of the pectoralis major muscle, is described. Primary and secondary breast augmentations in 241 procedures using the Allergan Style 410 implant resulted in a 0.0% rotation rate. Overall, the anatomic form-stable silicone gel breast implants, when placed subfascially, improve common complications such as capsular contracture and implant rupture with improved aesthetic outcomes and patient satisfaction.

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References

  1. Adams WP Jr (2003) Breast deformity caused by anatomical or teardrop implant rotation. Plast Reconstr Surg 111:2110–2111

    Article  PubMed  Google Scholar 

  2. Adams WP Jr, Potter JK (2005) Breast implants: materials and manufacturing past, present and future. In: Spear S, Willey SC, Robb GL, Hammond DC, Nahabedian MY (eds) Surgery of the breast: principles and art, 2nd edn. Lippincott Williams & Wilkins, Baltimore, MD, pp 424–437

    Google Scholar 

  3. Baeke JL (2002) Breast deformity caused by anatomical or teardrop implant rotation. Plast Reconstr Surg 109:2555–2564

    Article  PubMed  Google Scholar 

  4. Barone FE, Perry L, Keller T, Maxwell GP (1992) The biomechanical and histopathologic effects of surface texturing with silicone and polyurethane in tissue implantation and expansion. Plast Reconstr Surg 90:77–86

    Article  CAS  PubMed  Google Scholar 

  5. Bengtson BP, Van Natta BW, Murphy DK, Slicton A, Maxwell GP, for the Style 410 US Core Clinical Study Group (2007) Style 410 highly cohesive silicone breast implant core study results at 3 years. Plast Reconstr Surg 120:40S–48S

    Article  CAS  PubMed  Google Scholar 

  6. Bern S, Burd A, May JW Jr (1992) The biophysical and histologic properties of capsules formed by smooth and textured silicone implants in the rabbit. Plast Reconstr Surg 89:1037–1042

    CAS  PubMed  Google Scholar 

  7. Brink RR (1996) Sequestered fluid and breast implant malposition. Plast Reconstr Surg 98:679–684

    Article  CAS  PubMed  Google Scholar 

  8. Brown MH, Shenker R, Silver SA (2005) Cohesive silicone gel breast implants in aesthetic and reconstructive breast surgery. Plast Reconstr Surg 116:768–779

    Article  CAS  PubMed  Google Scholar 

  9. Burkhardt BR, Demas CP (1994) The effect of Siltex texturing and povidone-iodine irrigation on capsular contracture around saline inflatable breast implants. Plast Reconstr Surg 93:123–128

    CAS  PubMed  Google Scholar 

  10. Clugston PA, Perry LC, Hammond DC, Maxwell GP (1994) A rat model for capsular contracture: the effects of surface texturing. Ann Plast Surg 33:595–599

    Article  CAS  PubMed  Google Scholar 

  11. Cross PA (2003) Double capsule or capsule within a capsule: is there a difference? Br J Plast Surg 56:76

    PubMed  Google Scholar 

  12. Cunningham B (2007) The Mentor study on contour profile gel silicone MemoryGel breast implants. Plast Reconstr Surg 120:33S–39S

    Article  CAS  PubMed  Google Scholar 

  13. Danino AM, Basmacioglu P, Saito S, Rocher F, Blanchet-Bardon C, Revol M, Servant JM (2001) Comparison of the capsular response to the Biocell RTV and Mentor 1600 Siltex breast implant surface texturing: a scanning electron microscopic study. Plast Reconstr Surg 108:2047–2052

    Article  CAS  PubMed  Google Scholar 

  14. Fruhstorfer BH, Hodgson EL, Malata CM (2004) Early experience with an anatomical soft cohesive silicone gel prosthesis in cosmetic and reconstructive breast implant surgery. Ann Plast Surg 53:536–542

    Article  PubMed  Google Scholar 

  15. Goes JC, Landecker A (2003) Optimizing outcomes in breast augmentation: seven years of experience with the subfascial plane. Aesthetic Plast Surg 27:178–184

    Article  PubMed  Google Scholar 

  16. Hahn M, Kuner RP, Scheler P, Freidel K, Hoffmann G, Madjar H, Wallwiener D, Krainick-Strobel U (2008) Sonographic criteria for the confirmation of implant rotation and the development of an implant-capsule interaction (“interface”) in anatomically formed textured breast implants with texturised Biocell surface. Ultraschall Med 29(4):399–404

    Article  CAS  PubMed  Google Scholar 

  17. Hedén P, Jernbeck J, Hober M (2001) Breast augmentation with anatomical cohesive gel implants: the world’s largest current experience. Clin Plast Surg 28:531–552

    PubMed  Google Scholar 

  18. Hedén P, Nava MB, van Tetering J, Magalon G, Fourie le R, Brenner RJ, Lindsey LE, Murphy DK, Walker PS (2006) Prevalence of rupture in Inamed silicone breast implants. Plast Reconstr Surg 118:303–308

    Article  PubMed  CAS  Google Scholar 

  19. Heitmann C, Schreckenberger C, Olbrisch RR (1998) A silicone implant filled with cohesive gel: advantages and disadvantages. Eur J Plast Surg 21:329–332

    Article  Google Scholar 

  20. INAMED silicone-filled breast implants directions for use, smooth & BIOCELL texture. Allergan, Inc., Santa Barbara, CA, 2006

  21. Institute of Medicine (2000) Reoperations and specific local and perioperative complications. In: Bondurant S, Ernster V, Herdman R (eds) Safety of silicone breast implants. National Academy Press, Washington, DC, pp 114–178

    Google Scholar 

  22. Kulmala I, McLaughlin JK, Pakkanen M, Lassila K, Holmich LR, Lipworth L, Boice JD Jr, Raitanen J, Luoto R (2004) Local complications after cosmetic breast implant surgery in Finland. Ann Plast Surg 53:413–419

    Article  PubMed  Google Scholar 

  23. Maxwell GP, Baker MB (2005) Augmentation mammaplasty: general considerations. In: Spear SL, Willey SC, Robb GL, Hammond DC, Nahabedian MY (eds) Surgery of the breast: principles and art, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 1237–1260

    Google Scholar 

  24. Maxwell GP, Hammond DC (1993) Breast implants: smooth vs. textured. In: Habal MB, Woods JE, Morain WD, Parsons RW (eds) Advances in plastic and reconstructive surgery, vol 9. Mosby-Year Book, Inc., St Louis, MO, pp 209–220

    Google Scholar 

  25. Mentor MemoryGel Silicone Gel-Filled Breast Implants [package insert]. Mentor, Santa Barbara, CA, 2006

  26. Niechajev I, Jurell G, Lohjelm L (2007) Prospective study comparing two brands of cohesive gel breast implants with anatomic shape: 5-year follow-up evaluation. Aesthetic Plast Surg 31:697–710

    Article  PubMed  Google Scholar 

  27. Pandya AN, Dickson MG (2002) Capsule within a capsule: an unusual entity. Br J Plast Surg 55:455–456

    Article  PubMed  Google Scholar 

  28. Panettiere P, Marchetti L, Accorsi D (2004) Rotation of anatomic prostheses: a possible cause of breast deformity. Aesthetic Plast Surg 28:348–353

    Article  PubMed  Google Scholar 

  29. Peters W (2000) Current status of breast implant survival properties and the management of the woman with silicone gel breast implants. Can J Plast Surg 8:54–67

    Google Scholar 

  30. Spear SL, Baker JL Jr (1995) Classification of capsular contracture after prosthetic breast reconstruction. Plast Reconstr Surg 96:1119–1123

    Article  CAS  PubMed  Google Scholar 

  31. Spear SL, Heden P (2007) Allergan’s silicone gel breast implants. Expert Rev Med Devices 4:699–708

    Article  CAS  PubMed  Google Scholar 

  32. Tebbetts JB (2000) Patient acceptance of adequately filled breast implants using the tilt test. Plast Reconstr Surg 106:139–147

    Article  CAS  PubMed  Google Scholar 

  33. Tebbetts JB (2002) Achieving a predictable 24-hour return to normal activities after breast augmentation: part I. Refining practices by using motion and time study principles. Plast Reconstr Surg 109:273–290

    Article  PubMed  Google Scholar 

  34. Tebbetts JB (2006) Axillary endoscopic breast augmentation: processes derived from a 28-year experience to optimize outcomes. Plast Reconstr Surg 118:53S–80S

    Article  CAS  PubMed  Google Scholar 

  35. Young VL, Watson ME (2001) Breast implant research: where we have been, where we are, where we need to go. Clin Plast Surg 28:451–483, vi

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Rua Campos Bicudo, 98-conj. 111, São Paulo, SP, 04536-010, Brazil

    João Carlos Sampaio Góes

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  1. João Carlos Sampaio Góes
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Correspondence to João Carlos Sampaio Góes.

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Sampaio Góes, J.C. Breast Implant Stability in the Subfascial Plane and the New Shaped Silicone Gel Breast Implants. Aesth Plast Surg 34, 23–28 (2010). https://doi.org/10.1007/s00266-009-9429-6

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  • DOI: https://doi.org/10.1007/s00266-009-9429-6

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