Cohesive Silicone Gel Breast Implants in Aesthetic and Reconstructive Breast Surgery
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Notice bibliographique
Résumé
BACKGROUND: Cohesive silicone gel breast implants are composed of a textured silicone elastomer shell and are filled with cohesive silicone gel. Cohesive gel is formed by increasing the number of cross-links between gel molecules, which results in an implant that has better retention of shape and is less likely to fold or collapse, especially in the upper pole. METHODS: The initial 150 consecutive patients who received cohesive gel breast implants by the senior author (Brown) were included in the study. A retrospective chart review was carried out to analyze patient demographics, diagnosis, indication for cohesive gel selection, procedure performed, implant selected, and complications. All implants were manufactured by Inamed Aesthetics and were either style 410, CML, or CMH. RESULTS: One woman underwent unilateral augmentation for breast asymmetry and 117 women underwent bilateral breast augmentation. Of the 235 implants used, all were model 410 anatomical implants, with the majority being MM, MF, FM, or FF styles. Complications occurred in four of 118 patients (3.4 percent). There was one immediate postoperative hematoma, two cases of unilateral Baker II contracture, and one case of asymmetry related to excessive lowering of an inframammary fold. There were no cases of rotation, malposition, infection, rippling, or loss of implant integrity. Thirty-two women underwent breast reconstruction with cohesive gel implants. A total of 50 implants were used in the 32 patients (27 style 410, 19 style CML, and four style CMH). Complications occurred in six of 32 patients (18.8 percent), although five of the six were minor and only one of 32 patients (3.1 percent) required a secondary procedure. There were two seromas, three capsular contractures, and one implant exposure following a skin-sparing mastectomy. CONCLUSIONS: Cohesive gel implants have the potential for providing a natural breast shape, minimizing the risk of postoperative rippling, and providing a greater degree of safety should the implant lose its integrity. The wide variety of implant shapes and sizes allows for great flexibility in reconstructive surgery, in cases of breast asymmetry, and in primary breast augmentation. Results in our initial 150 patients have been excellent, with a high degree of patient satisfaction, excellent aesthetic outcomes, and very few implant-related complications. Cohesive gel implants are likely to play an important role in aesthetic and reconstructive breast surgery when silicone gel implants are reintroduced into the North American market.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle