Abstract
Introduction: Capsular contracture most often leads to implant revision surgery for aesthetic or reconstructive purposes. However, little is known about which operation is chosen when revision surgery has to be performed. We performed analysis of revision indications and performed revision surgery considering implant removal or replacement and additional surgical procedures. To our knowledge, this study presents the largest German single-center analysis regarding implant revision surgery after the onset of complications. Methods: Retrospective 10-year data analysis of a single-center population undergoing breast implant revision surgery. Results: Capsular contracture was the most frequent finding before reoperation, both removal and replacement (p < 0.05). It was linked to longer duration of in situ implant placement (p < 0.05) and more frequently in reconstructive patients (p < 0.05). Implant replacement was performed more often before definite implant removal for reconstructive patients (p < 0.05). Mean duration of in situ implant placement before definite removal was lower for reconstructive patients (p = 0.005). Overall reconstructive patients were older than aesthetic patients (p < 0.05). After implant removal, 61.7% of aesthetic patients chose to undergo mastopexy, 54.7% of reconstructive patients opted for autologous breast reconstruction, and 25.4% did not choose an additional surgical procedure after implant removal. Conclusion: Significant differences are observed for reconstructive and aesthetic patients regarding indication leading to revision surgery, time of revision surgery, and the type of performed revision surgery itself. After implant removal, more than 60% of aesthetic patients undergo mastopexy, more than half of reconstructive patients choose autologous breast reconstruction, and over a quarter of patients choose no additional surgical procedures.
References
1.
Kühn
S
, Rieger
UM
. Ästhetische Operationen - nimmt der Trend zu? gynäkologische praxis. 2018
;(44/2):309-316.2.
International Society of Aesthetic Plastic Surgery [Internet]. ISAPS INTERNATIONAL SURVEY ON AESTHETIC/COSMETIC PROCEDURES performed in
2018
. Available from https://www.isaps.org/wp-content/uploads/2019/12/ISAPS-Global-Survey-Results-2018-new.pdf3.
Champaneria
MC
, Wong
WW
, Hill
ME
, Gupta
SC
. The evolution of breast reconstruction: a historical perspective
. World J Surg
. 2012
Apr
;36
(4
):730
–42
.
[PubMed]
0364-23134.
Billner
M
, Wirthmann
A
, Reif
S
, Rieger
UM
. Poly Implant Prothèse and Rofil Substandard Breast Implant Explantations from a Large German Single Centre from 2011 to 2014: A Comparative Study
. Aesthetic Plast Surg
. 2016
Aug
;40
(4
):507
–13
.
[PubMed]
0364-216X5.
Gabriel
SE
, Woods
JE
, O’Fallon
WM
, Beard
CM
, Kurland
LT
, Melton
LJ
3rd. Complications leading to surgery after breast implantation
. N Engl J Med
. 1997
Mar
;336
(10
):677
–82
.
[PubMed]
0028-47936.
Coroneos
CJ
, Selber
JC
, Offodile
AC
2nd, Butler
CE
, Clemens
MW
. US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 Patients
. Ann Surg
. 2019
Jan
;269
(1
):30
–6
.
[PubMed]
0003-49327.
de Boer
M
, Colaris
M
, van der Hulst
RR
, Cohen Tervaert
JW
. Is explantation of silicone breast implants useful in patients with complaints?
Immunol Res
. 2017
Feb
;65
(1
):25
–36
.
[PubMed]
0257-277X8.
Van Slyke
AC
, Carr
M
, Carr
NJ
. Not All Breast Implants Are Equal: A 13-Year Review of Implant Longevity and Reasons for Explantation
. Plast Reconstr Surg
. 2018
Sep
;142
(3
):281e
–9e
.
[PubMed]
0032-10529.
Bachour
Y
, Bargon
CA
, de Blok
CJ
, Ket
JC
, Ritt
MJ
, Niessen
FB
. Risk factors for developing capsular contracture in women after breast implant surgery: A systematic review of the literature
. J Plast Reconstr Aesthet Surg
. 2018
Sep
;71
(9
):e29
–48
.
[PubMed]
1748-681510.
Chopra
K
, Gowda
AU
, Kwon
E
, Eagan
M
, Grant Stevens
W
. Techniques to Repair Implant Malposition after Breast Augmentation: A Review
. Aesthet Surg J
. 2016
Jun
;36
(6
):660
–71
.
[PubMed]
1090-820X11.
Maxwell
GP
, Van Natta
BW
, Bengtson
BP
, Murphy
DK
. Ten-year results from the Natrelle 410 anatomical form-stable silicone breast implant core study
. Aesthet Surg J
. 2015
Feb
;35
(2
):145
–55
.
[PubMed]
1090-820X12.
Borenstein
A
, Friedman
O
. Combined Breast Implant Explantation and Multilevel Mastopexy Technique
. Plast Reconstr Surg Glob Open
. 2019
Sep
;7
(9
):e2429
.
[PubMed]
2169-757413.
Netscher
DT
, Sharma
S
, Thornby
J
, Peltier
M
, Lyos
A
, Fater
M
, et al. Aesthetic outcome of breast implant removal in 85 consecutive patients
. Plast Reconstr Surg
. 1997
Jul
;100
(1
):206
–19
.
[PubMed]
0032-105214.
Paydar
KZ
, Kohan
E
, Hansen
SL
, Roostaeian
J
, Gradinger
GP
. Long-term effects of breast aging in patients undergoing explantation: analysis of breast aesthetics from before augmentation to after explantation
. Ann Plast Surg
. 2013
Apr
;70
(4
):427
–31
.
[PubMed]
0148-704315.
Graf
RM
, Closs Ono
MC
, Pace
D
, Balbinot
P
, Pazio
AL
, de Paula
DR
. Breast Auto-augmentation (Mastopexy and Lipofilling): An Option for Quitting Breast Implants
. Aesthetic Plast Surg
. 2019
Oct
;43
(5
):1133
–41
.
[PubMed]
0364-216X16.
Gurunluoglu
R
, Kubek
E
, Arton
J
. Dual pedicle mastopexy technique for reorientation of volume and shape after subglandular and submuscular breast implant removal
. Eplasty
. 2013
Sep
;13
:e48
.
[PubMed]
1937-571917.
Hönig
JF
, Frey
HP
, Hasse
FM
, Hasselberg
J
. Inferior pedicle autoaugmentation mastopexy after breast implant removal
. Aesthetic Plast Surg
. 2010
Aug
;34
(4
):447
–54
.
[PubMed]
0364-216X18.
Gurunluoglu
R
, Sacak
B
, Arton
J
. Outcomes analysis of patients undergoing autoaugmentation after breast implant removal
. Plast Reconstr Surg
. 2013
Aug
;132
(2
):304
–15
.
[PubMed]
0032-105219.
Collett
DJ
, Rakhorst
H
, Lennox
P
, Magnusson
M
, Cooter
R
, Deva
AK
. Current Risk Estimate of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants.
Plast Reconstr Surg. 2019
;143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma):30S-40S. 20.
Ramos-Gallardo
G
, Cuenca-Pardo
J
, Rodríguez-Olivares
E
, Iribarren-Moreno
R
, Contreras-Bulnes
L
, Vallarta-Rodríguez
A
, et al. Breast Implant and Anaplastic Large Cell Lymphoma Meta-Analysis
. J Invest Surg
. 2017
Feb
;30
(1
):56
–65
.
[PubMed]
0894-193921.
Leberfinger
AN
, Behar
BJ
, Williams
NC
, Rakszawski
KL
, Potochny
JD
, Mackay
DR
, et al. Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic Review
. JAMA Surg
. 2017
Dec
;152
(12
):1161
–8
.
[PubMed]
2168-625422.
Rastogi
P
, Deva
AK
, Prince
HM
. Breast Implant-Associated Anaplastic Large Cell Lymphoma
. Curr Hematol Malig Rep
. 2018
Dec
;13
(6
):516
–24
.
[PubMed]
1558-821123.
Spear
SL
, Murphy
DK
; Allergan Silicone Breast Implant U.S. Core Clinical Study Group
. Natrelle round silicone breast implants: core Study results at 10 years
. Plast Reconstr Surg
. 2014
Jun
;133
(6
):1354
–61
.
[PubMed]
0032-105224.
Galdiero
M
, Larocca
F
, Iovene
MR
, Martora
F
, Pieretti
G
, D’Oriano
V
, et al. Microbial Evaluation in Capsular Contracture of Breast Implants
. Plast Reconstr Surg
. 2018
Jan
;141
(1
):23
–30
.
[PubMed]
0032-105225.
Li
S
, Chen
L
, Liu
W
, Mu
D
, Luan
J
. Capsular Contracture Rate After Breast Augmentation with Periareolar Versus Other Two (Inframammary and Transaxillary) Incisions: A Meta-Analysis
. Aesthetic Plast Surg
. 2018
Feb
;42
(1
):32
–7
.
[PubMed]
0364-216X26.
Calobrace
MB
, Stevens
WG
, Capizzi
PJ
, Cohen
R
, Godinez
T
, Beckstrand
M
. Risk Factor Analysis for Capsular Contracture: A 10-Year Sientra Study Using Round, Smooth, and Textured Implants for Breast Augmentation. Plast Reconstr Surg. 2018
;141(4S Sientra Shaped and Round Cohesive Gel Implants):20S-28S.27.
Vieira
VJ
, D’Acampora
A
, Neves
FS
, Mendes
PR
, Vasconcellos
ZA
, Neves
RD
, et al. Capsular Contracture In Silicone Breast Implants: Insights From Rat Models
. An Acad Bras Cienc
. 2016
Sep
;88
(3
):1459
–70
.
[PubMed]
0001-376528.
Rohrich
RJ
, Parker
TH
3rd. Aesthetic management of the breast after explantation: evaluation and mastopexy options
. Plast Reconstr Surg
. 2007
Jul
;120
(1
):312
–5
.
[PubMed]
0032-105229.
Nano
MT
, Gill
PG
, Kollias
J
, Bochner
MA
, Malycha
P
, Winefield
HR
. Psychological impact and cosmetic outcome of surgical breast cancer strategies
. ANZ J Surg
. 2005
Nov
;75
(11
):940
–7
.
[PubMed]
1445-143330.
Ng
SK
, Hare
RM
, Kuang
RJ
, Smith
KM
, Brown
BJ
, Hunter-Smith
DJ
. Breast Reconstruction Post Mastectomy: Patient Satisfaction and Decision Making
. Ann Plast Surg
. 2016
Jun
;76
(6
):640
–4
.
[PubMed]
0148-704331.
Oiz
B
. Reconstrucción mamaria y beneficio psicológico
. An Sist Sanit Navar
. 2005
;28
Suppl 2
:19
–26
.
[PubMed]
1137-662732.
Wilkins
EG
, Cederna
PS
, Lowery
JC
, Davis
JA
, Kim
HM
, Roth
RS
, et al. Prospective analysis of psychosocial outcomes in breast reconstruction: one-year postoperative results from the Michigan Breast Reconstruction Outcome Study
. Plast Reconstr Surg
. 2000
Oct
;106
(5
):1014
–25
.
[PubMed]
0032-105233.
Sawant
KV
, Xu
R
, Cox
R
, Hawkins
H
, Sbrana
E
, Kolli
D
, et al. Chemokine CXCL1-mediated neutrophil trafficking in the lung: role of CXCR2 activation
. J Innate Immun
. 2015
;7
(6
):647
–58
.
[PubMed]
1662-811X© 2020 S. Karger AG, Basel
2020
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