scholarly journals A Rare Complication Following Breast Implant Surgery: Capsular Contracture with a Cutaneous Silicone Fistula after Breast Reconstruction with Silicone Gel Implants

Breast Care ◽  
2011 ◽  
Vol 6 (1) ◽  
pp. 51-53 ◽  
Author(s):  
Klaus-Jürgen Walgenbach ◽  
Christiane Kuhl ◽  
Christian Rudlowski ◽  
Martin Poelcher ◽  
Axel Sauerwald ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Rare Complication ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Implant Surgery ◽  
Silicone Gel

scholarly journals New Evaluation Procedure for Multi-Dimensional Mechanical Strains and Tangent Moduli of Breast Implants: IDEAL IMPLANT® Structured Breast Implant Compared to Silicone Gel Implants

2019 ◽  
Vol 6 (2) ◽  
pp. 43 ◽  
Author(s):  
Harold J. Brandon ◽  
Larry S. Nichter ◽  
Dwight D. Back
Keyword(s):  
Breast Implant ◽  
Capsular Contracture ◽  
Compressive Load ◽  
Evaluation Procedure ◽  
Shape Stability ◽  
Silicone Gel ◽  
Tangent Moduli ◽  
Compressive Loads ◽  
Cohesive Gel ◽  
The Ideal

The IDEAL IMPLANT® Structured Breast Implant is a dual lumen saline-filled implant with capsular contracture and deflation/rupture rates much lower than single-lumen silicone gel-filled implants. To better understand the implant’s mechanical properties and to provide a potential explanation for these eight-year clinical results, a novel approach to compressive load testing was employed. Multi-dimensional strains and tangent moduli, metrics describing the shape stability of the total implant, were derived from the experimental load and platen spacing data. The IDEAL IMPLANT was found to have projection, diametric, and areal strains that were generally less than silicone gel implants, and tangent moduli that were generally greater than silicone gel implants. Despite having a relatively inviscid saline fill, the IDEAL IMPLANT was found to be more shape stable compared to gel implants, which implies potentially less interaction with the capsule wall when the implant is subjected to compressive loads. Under compressive loads, the shape stability of a higher cross-link density, cohesive gel implant was unexpectedly found to be similar to or the same as a gel implant. In localized diametric compression testing, the IDEAL IMPLANT was found to have a palpability similar to a gel implant, but softer than a cohesive gel implant.

Capsular Contracture After Cosmetic Breast Implant Surgery in Denmark

2001 ◽  
Vol 47 (4) ◽  
pp. 359-366 ◽  
Author(s):  
Kim Kj??ller ◽  
Lisbet R. H??lmich ◽  
Poul Harboe Jacobsen ◽  
S??ren Friis ◽  
Jon Fryzek ◽  
...  
Keyword(s):  
Breast Implant ◽  
Capsular Contracture ◽  
Implant Surgery

Current Concepts in Capsular Contracture: Pathophysiology, Prevention, and Management

2021 ◽  
Author(s):  
Tyler Safran ◽  
Hillary Nepon ◽  
Carrie K. Chu ◽  
Sebastian Winocour ◽  
Amanda Murphy ◽  
...  
Keyword(s):  
United States ◽  
Breast Implant ◽  
Capsular Contracture ◽  
The United States ◽  
Current Paper ◽  
Common Complication ◽  
Implant Surgery ◽  
Inflammatory Cascade ◽  
Multiple Factors ◽  
Prevention And Treatment

AbstractOver 400,000 women in the United States alone will have breast implant surgery each year. Although capsular contracture represents the most common complication of breast implant surgery, surgeons continue to debate the precise etiology. General agreement exists concerning the inflammatory origin of capsular fibrosis, but the inciting events triggering the inflammatory cascade appear to be multifactorial, making it difficult to predict why one patient may develop capsular contracture while another will not. Accordingly, researchers have explored many different surgical, biomaterial, and medical therapies to address these multiple factors in an attempt to prevent and treat capsular contracture. In the current paper, we aim to inform the reader on the most up-to-date understanding of the pathophysiology, prevention, and treatment of capsular contracture.

scholarly journals Comprehensive Comparison Between Shaped Versus Round Implants for Breast Reconstruction: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 41 (1) ◽  
pp. 34-44 ◽  
Author(s):  
So-Eun Han ◽  
Kyeong-Tae Lee ◽  
Saik Bang
Keyword(s):  
Breast Reconstruction ◽  
Meta Analysis ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Relative Risks ◽  
Patient Reported ◽  
Aesthetic Results ◽  
Retrospective Cohort Studies

Abstract Background Prosthetic breast reconstruction has been gaining popularity and a variety of implant options are currently available. Therefore, it is important to evaluate the safety and efficacy of newly developed shaped implants compared with those of conventional round implants. To date, few studies have investigated the outcomes of breast reconstruction with shaped versus round implants. Objectives The present study aimed to comprehensively compare, via meta-analytic methodology, shaped and round breast implant reconstruction in terms of complication profiles and aesthetic satisfaction. Methods PubMed/MEDLINE, Ovid, and Cochrane databases were searched to identify relevant studies presenting the complication rates for shaped and round implant groups. The relative risks of the following complications between the groups were calculated: infection, seroma, capsular contracture, rupture, rippling, reconstruction failure, and implant exchange or removal. Outcomes of aesthetic satisfaction included aesthetic results and patient-reported outcomes. Results Meta-analysis of 8 retrospective cohort studies, representing 2490 cases of implant-based breast reconstruction, was performed. There were no significant differences in the risks of infection, seroma, capsular contracture, and reconstruction failure between the 2 groups. The risks of implant rupture and rippling were significantly reduced with shaped implants. In a subgroup analysis of shaped/textured and round/smooth implants, the risk of infection was significantly enhanced in the former, whereas incidences of other complications, including capsular contracture and reconstruction failure, were similar. Aesthetic satisfaction analysis of the 2 groups demonstrated similar outcome scores with favorable overall results. Conclusions Our results suggest that both shaped and round implants might provide favorable breast reconstruction outcomes with similarly low complication rates and aesthetic results. Level of Evidence: 4

scholarly journals Periprosthetic Fluid Analysis in the Diagnosis of Breast Implant Infections Using Cell Count and Differential

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Christopher N Stewart ◽  
Bill B Liu ◽  
Eugene E Zheng ◽  
Sue-Mi C Tuttle
Keyword(s):  
Breast Reconstruction ◽  
Cell Count ◽  
Clinical Decision Making ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Accurate Diagnosis ◽  
Level Of Evidence ◽  
Fluid Analysis ◽  
Neutrophil Percentage ◽  
Periprosthetic Fluid

Abstract Background One of the most devastating complications following implant-based breast reconstruction is periprosthetic infection. Making a prompt and accurate diagnosis has been a challenge as plastic surgeons are limited by nonspecific systemic markers of infection, clinical examination findings, or imaging modalities. Objectives The aim of this study is to evaluate the use of periprosthetic fluid using cell count and differential as an aid in the diagnosis of infection. Methods This is a retrospective chart review. The authors selected patients who underwent breast reconstruction and had periprosthetic fluid analysis during the previous 10 years based on CPT 89051 (cell count and differential, body fluid). Only patients with clinical concerns for infection were included (cellulitis, fever, etc.); all others were excluded. Results A total of 54 samples were included in the study. Twenty-seven samples were associated with periprosthetic breast infections based on positive cultures or intraoperative findings consistent with infection. On fluid analysis, those with infection had a significantly higher neutrophil percentage (84.2% vs 19.3%, P < 0.0001). A cutoff value of 77% neutrophils had a sensitivity of 89% and a specificity of 93% in diagnosing infection. Delayed treatment in patients with high neutrophil percentage was associated with poorer outcomes. Lastly, there was a strong correlation between higher neutrophil percentage and increased rate of capsular contracture. Conclusions Early and accurate diagnosis of periprosthetic breast infections can lead to earlier treatment and potentially improved the outcomes. Aspiration and analysis of periprosthetic fluid for neutrophil percentage can be a reliable method to guide clinical decision making. Level of Evidence: 3

scholarly journals Thoracic migration of silicone gel after breast implant rupture: a case report and literature review

2021 ◽  
Author(s):  
Benedetta Fanelli ◽  
Marco Marcasciano ◽  
Stefano Lovero ◽  
Luca Codolini ◽  
Donato Casella ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Biological Membrane ◽  
Breast Implant ◽  
Granulomatous Inflammation ◽  
Breast Implants ◽  
Silicone Implants ◽  
Axillary Lymph ◽  
Implant Rupture ◽  
Silicone Gel ◽  
Breast Implant Rupture

AbstractNowadays silicone is a widespread material for medical devices. In particular, it is commonly used for implants manufacturing, for that patients undergoing breast augmentation or breast reconstruction after mastectomy. However, the use of silicone implants is not free from risks. Ruptures of silicone breast implants are uncommon, in general post-traumatic or iatrogenic, and usually related to implant’s wall weakness of unknown origin but probably due to biochemical reactions that cause wall rupture. As a consequence of a rupture, silicone gel from damaged implants may have a continuity migration to the chest wall, axillae, and upper extremities, resulting in granulomatous inflammation or siliconoma, or a lymphatic migration to axillary lymph nodes. In this regard, silicone thoracic migration is extremely rare, and nowadays a leakage is unlikely to happen with more modern cohesive silicone gel implants. Nevertheless, procedures such as thoracic surgery and thoracotomies may be responsible for accidental breast implant rupture, capsular discontinuity, and eventually intrathoracic silicone migration, especially when dealing with older generations of breast implants. We report a rare case of a 75-year-old woman presenting with pleural silicone effusion, 18 years after a right breast reconstruction for breast cancer, followed by right upper lobe resection for a lung carcinoma. A combination of muscular flap and DTI pre-pectoral breast reconstruction with biological membrane (ADM) has been used for treatment. Literature was reviewed for cases of breast implants free silicone localization in the chest cavity, focusing on previous surgeries, anamnestic relevances, and surgical management.Level of Evidence: Level V, risk/prognostic study.

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