Search

Background Rupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants. Methods We performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone), duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management. Results Forty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case), microfat graft (2 case), removal only (14 case), and follow-up loss (17 case). Conclusions Saline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

INTRODUÇÃO: Os implantes de silicone são utilizados em diversas regiões do corpo. Em mulheres, a flacidez da musculatura do tríceps constitui um dos grandes incômodos; por outro lado, em homens, a hipertrofia da região do bíceps e tríceps é sinal de masculinidade e beleza. O objetivo deste trabalho é descrever uma técnica relativamente simples e reprodutível para aumento da circunferência do braço ou para correção de flacidez de grau leve a moderado com fins estéticos, com uso de implantes de silicone gel e elastômero. MÉTODO: Foram selecionados e operados 32 pacientes, com a introdução de no mínimo 2 implantes e no máximo 4 implantes por braço. RESULTADOS: Houve melhora significativa da estética dos braços dos pacientes estudados, com índice de satisfação superior a 90%. A melhora foi sentida na avaliação estática e em movimento do braço, grande queixa da maioria de pacientes do sexo feminino. CONCLUSÕES: A técnica cirúrgica apresentada para braquioplastia de aumento é segura e reprodutível, sendo mais uma opção no arsenal terapêutico do cirurgião plástico em sua busca por resultados melhores, com incisões menores. BACKGROUND: Silicone implants are used in several regions of the body. In women, sagging of the triceps muscle is a major concern. Meanwhile, men consider biceps and triceps hypertrophy to be a symbol of masculinity and beauty. Here, we describe a relatively simple and reproducible procedure used for esthetic purposes to increase arm circumference or correct mild to moderately sagging skin using gel silicone implants and elastomer. METHODS: Thirty-two patients were selected and operated on. Two to four implants per arm were introduced. RESULTS: The esthetics of the arms improved significantly in the studied patients, with a satisfaction rate exceeding 90%. The procedure improved static evaluation and arm movement, which were the major complaints of majority of the female patients. CONCLUSIONS: The surgical technique presented for augmentation brachioplasty is safe and reproducible, and should be considered by plastic surgeons in an attempt to achieve better results with smaller incisions.

Background: Two-year safety and efficacy data were presented to the Canadian Therapeutic Products Directorate Scientific Advisory Panel, in Ottawa, Ontario, Canada. Methods: The 955 women enrolled in the 10-year, multicenter, Mentor MemoryGel study were distributed into four cohorts: 572 augmentation patients, 123 revision-augmentation patients, 191 reconstruction patients, and 69 revision-reconstruction patients. The surgeons in the study received an intensive clinical educational program in addition to the protocol. Results: Mentor’s 2-year study results indicate that the risk of any complication or reoperation at some point through 2 years after implant surgery is 24.5 percent for primary augmentation patients, 30.2 percent for revision-augmentation patients, 42.9 percent for primary reconstruction patients, and 41.8 percent for revision-reconstruction patients. The rupture rates reported from the magnetic resonance imaging cohort were 0 percent for all groups. Patients reoperated on at least one time were as follows: 9.4 percent for primary augmentation, 12.8 percent for revision-augmentation, 27.3 percent for primary reconstruction, and 19.4 percent for revision-reconstruction. Also, 2.4 percent of primary augmentation patients, 7.3 percent of revision-augmentation patients, 8.9 percent of primary, and 11.6 percent of reconstruction patients had their implants removed, with patient choice and capsular contracture being the most common reasons. Conclusions: The data from the Mentor CPG Gel Study resulted in approval of these implants for general use on October 20, 2006. The educational program resulted in improved clinical outcomes and probably should be required for all surgeons using the devices.

Bioplastique, a biphasic polymer of textured dimetylpolysiloxane is reported to be useful in filling small soft tissue defects. The microparticles range in size from 100 to 600 p and are suspended in a hydrogel carier from the family of the plasdones. The bioexcretable gel component is rapidly phagocytized and replaced by fibrin-like matrix with in a few days. In this study it is aimed to observe the local and systemic effects of Bioplastique and gel silicone in comparison. Our study in rabbit ears has shown that Bioplastique caused severe foreign body reaction in injection site and showed no migration to lymph nodes. On the other hand, silicone gel caused fibrous encapsulation and showed migration to lymph nodes, and formation of granulomatous reaction.

An experimental study is recorded that compares the use of soft gel silicone implants with, and without, a silicone sheet Dacron felt spacer, using the scalp of the guinea pig as a test site. Capsular contractures were produced in 45 percent of the control animals without the spacer. This was documented histologically to be related to a migration of muscle fibroblasts and could be prevented by the fixation of the Dacron felt to the pocket floor peripheral to the implant.