Guinea pig studies published in 1973 demonstrated that capsules surrounding implanted silicone elastomer blocks resolved within four weeks following removal of the blocks. This study has prompted many surgeons to leave capsules in place when implants are removed, to avoid the morbidity, possible deformity, and expense of total capsulectomy. Recent evidence, however, has suggested that […]
Archive for the 'Plastic surgery' Category
Mammography is not accurate enough to predict implant rupture in the majority of patients. Recent studies have demonstrated a sensitivity rate of only 11 % and 16.2%. This is particularly significant, because about 80% of all silicone gel breast implants inserted between 1973 and 1986 are currently thought to be ruptured. In the present study, […]
At exploration, a large, dense, firm, white, capsule-covered cystic mass was encountered, embedded within scar tissue. When the thick wall was opened, the cystic cavity (Figure 13) contained about 50 mL of a brown, watery, serous fluid. The capsule and adjacent scar tissue were completely resected. Histological section showed a cystic mass with epithelial lining. […]
Figure 11 shows a large calcified mass posteriorly in breast tissue. The patient’s silicone gel implants had been removed five years previously, but her calcified capsules were left in situ. She had requested that they not be removed, to avoid a secondary deformity. Over the subsequent five years, this area of calcification had not decreased in […]
Capsular calcification Calcification of breast implant capsules has been demonstrated in 16 to 17% of two large series of patients with silicone gel breast implants. This study demonstrated that calcification could often be predicted preoperatively. It presented as areas of stipling on a xeroradiomammogram (Figure 9) and mammogram (Figure 10). Complications from retained capsules
Silicone globules If the size of the herniation was large, implant rupture was more likely. Figure 4 shows a large implant herniation superiorly. At surgery, the implant was ruptured at this site. Figure 5 shows a similar large herniation inferiorly. This implant was also ruptured at this site at surgery.
RESULTS Implant rupture Mammography is not accurately able to predict implant rupture in the majority of patients. In spite of this limitation, the current study indicates that two mammographic findings suggest implant rupture: major implant herniation and the appearance of silicone globules outside the margin of the implant. Implant herniation