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Smooth Prosthesis: Our Experience and Current State of Art in the Use of Smooth Sub-muscular Silicone Gel Breast Implants

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  • Breast Surgery
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Abstract

Background

The objective of this clinical review is to provide an overview of the use of silicone gel-filled breast implants placed in the sub-muscular position, with a focus on complication rates reported for both smooth and textured implants. Furthermore, our experience in this field is also reviewed.

Methods

MEDLINE, EMBASE, Web of Science, Scopus, the Cochrane Central and Google Scholar databases were reviewed to identify the literature related to smooth breast implants. Each article was reviewed by two independent reviewers to ensure all relevant publications were identified. The literature search identified 98 applicable articles. Of these, just a few articles were found to have a therapeutic level of evidence. The reference lists in each relevant paper were screened manually to include relevant papers not found through the initial search.

Results

Eight articles report the risk of capsular contracture when the breast implants were placed in the sub-muscular position. Six of these articles report a similar rate of capsular contracture in smooth and textured implants. Local complications such as wrinkling, late seroma and double capsules were found to be associated with the use of textured breast implants (4 articles). All articles concerning BIA-ALCL reported a total absence occurring in smooth breast implants. All cases have been associated with textured mammary prostheses.

Conclusion

With our expertise in the field and the results of this up-to-date literature review, it can be concluded that there are no significant advantages of using one type of implant surface over the other when placed in the sub-pectoral position.

Level of Evidence V

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.

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Authors and Affiliations

  1. Clinic of Plastic and Reconstructive Surgery, Department of Medical Area (DAME), Academic Hospital of Udine, University of Udine, Udine, Italy

    Nicola Zingaretti, Daria Almesberger & Pier Camillo Parodi

  2. School of Medicine and Psychology, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy

    Francesca Galvano

  3. Clinic of Plastic and Reconstructive Surgery, Presidio Ospedaliero Villa Letizia, L’Aquila, Italy

    Paolo Vittorini

  4. SODC Chirurgia Ricostruttiva e Chirurgia Della Mano, AOU Ospedali Riuniti, Ancona, Italy

    Francesco De Francesco & Michele Riccio

  5. Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Ancona, Italy

    Michele Riccio, Luca Vaienti & Pier Camillo Parodi

  6. Department of Plastic Surgery, IRCCS Policlinico San Donato, University of Milan, Milan, Italy

    Luca Vaienti

  7. Department of Plastic Reconstructive Surgery, c/o Ospedale “S. Maria Della Misericordia”, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy

    Nicola Zingaretti

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Correspondence to Nicola Zingaretti.

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Zingaretti, N., Galvano, F., Vittorini, P. et al. Smooth Prosthesis: Our Experience and Current State of Art in the Use of Smooth Sub-muscular Silicone Gel Breast Implants. Aesth Plast Surg 43, 1454–1466 (2019). https://doi.org/10.1007/s00266-019-01464-9

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