Abstract
Silicone breast implants are used worldwide for breast augmentation. After an axillary, periareolar or inframmary incision has been made to create an adequately sized pocket; the surgeon usually uses his or her fingers to insert the implant. The use of fingers makes the insertion process time-consuming, a few minutes or more. There are some complications, including need to ensure that the incision is long enough for the implant to be inserted, scar hypertrophy caused by implant insertion friction damage to the edge of incision, and the occasional need to ask the surgical assistant to lend more fingers to facilitate satisfactory insertion and placement. In addition, the use of gloved fingers to repeatedly push on the implant can increase the risk of contamination, postoperative silicone microleakage, and capsular contracture. To resolve these problems, we developed an improved silicone breast implant injector (reusable stainless steel 2007; single use polypropylene 2018) that can be used more easily than fingers and other “no touch” devices. From 2013 to 2017, the first author, a plastic surgeon at our clinic, used the 2007 reusable stainless steel injector to perform breast augmentations in 53 patients (Ave. age 23.8 years; range 19–67 years), 5 (8.8%) receiving 250-ml implants, 41 (77.4%) 251–300-ml implants, and 7 (13.8%) 301–400-ml implants. Overall, results were satisfactory except for two patients (3.7%) in whom capsular contracture occurred. There were no ruptures. Use of the injector made it possible to shorten the length of the incisions from the traditional 4–7 to 3–4 cm and expedited insertion time from a few minutes to a few seconds. This “no touch” insertion technique reduced implant damage caused by finger pushing, leading to a decrease in silicone microleakage and capsular contracture rate. It was performed with no friction trauma to the incision edge or harm to the surgeon’s fingers. It was found to be an effective alternative operative tool for the insertion of silicone breast implants.
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The first author holds patents on both versions of the device. The authors declare that they have no conflicts of interest to disclose.
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Augmentation via axillary incision. A short 3 cm incision is made on the axilla, and a breast pocket is created for implant insertion by dissection. The injector is then used to insert implant in just seconds without the need for finger insertion on the implant. The edge of the skin incision is not damaged. (MP4 42471 kb)
Augmentation via upper half marginal incision. A short 3 cm incision is made on the upper half of the areolar margin, and a breast pocket is created for implant insertion by dissection. The injector is then used to insert implant in just seconds without the need for finger insertion on the implant. The edge of the skin incision is not damaged. (MP4 44017 kb)
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Tsao, SB., Wu, CC. Silicone Breast Implant Injector: A Retooled Breast Augmentation Device. Aesth Plast Surg 45, 95–99 (2021). https://doi.org/10.1007/s00266-020-01966-x
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DOI: https://doi.org/10.1007/s00266-020-01966-x